Background: A major concern has recently been raised regarding the association between glucagon-like peptide-1 receptor agonists (GLP-1RAs), especially for liraglutide and semaglutide, and an increased risk of suicide or self-harm. However, the evidence supporting this association remains extremely limited.
Methods: Using 2016-2020 national Medicare Claims data, we conducted a population-based, new-user cohort study that included individuals with type 2 diabetes (T2D) who were newly prescribed a GLP-1RA or a sodium-glucose cotransporter 2 inhibitors (SGLT2i). We employed 1:1 propensity score matching to control for potential confounding at baseline and used a Cox proportional hazards regression to estimate the hazard ratio (HR) and 95% confidence intervals (CI) of the suicide/self-harm. A secondary analysis with dipeptidyl peptidase 4 inhibitor (DPP4i) as the comparator was also performed.
Results: We identified 41,894 Medicare beneficiaries with T2D who initiated either a GLP-1RA inhibitor or an SGLT2i. The incidence rate of suicide/self-harm among GLP-1RA users and SGLT2i users were 42.79 cases and 41.84 cases per 1,000 person-years, respectively. There was no significant association between GLP-1RAs and an increased risk of suicide/self-harm compared with SGLT2i (HR, 1.02; 95%CI, 0.91-1.14). In the secondary analysis, GLP-1RAs were significantly associated with a lower risk of suicide/self-harm than DPP4i (HR, 0.77; 95%CI, 0.70-0.85).
Conclusion: Among Medicare beneficiaries with T2D, GLP-1RAs were not associated with an increased risk of suicide/self-harm. Future research is needed especially in younger populations to confirm these findings.
H. Tang: None. Y. Lu: None. W.T. Donahoo: None. J. Bian: None. J. Guo: None.
