CompletedNCT07513259Updated Aug 17, 2026Results posted

Pre-Diagnosis GLP-1 Receptor Agonist Use and Post-Cancer Mortality in Adults With Obesity and Type 2 Diabetes

An observational study in Obesity & Overweight, Diabetes Mellitus Type 2 and Neoplasms, sponsored by Chung Shan Medical University. Completed at 1 site in Taiwan. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-17.

Sponsored by Chung Shan Medical University · Observational

Study type: Observational
Model: Cohort
Time perspective: Retrospective
Enrollment: 203,424
Ages: 18 Years and older
Sex: All

Study summary

This study will examine whether the type of diabetes treatment used before cancer diagnosis is associated with survival and serious complications after obesity-associated cancer in adults with obesity and type 2 diabetes. The study focuses on glucagon-like peptide-1 receptor agonists (GLP-1 RA) and compares them with other commonly used glucose-lowering therapies, including SGLT2 inhibitors, DPP-4 inhibitors, sulfonylureas, metformin, and usual care. Using de-identified electronic health record data from the TriNetX US Collaborative Network, the study will assess whether patients who used GLP-1 RA before cancer diagnosis have different risks of death, hospitalization, sepsis, and other major outcomes after cancer diagnosis. This is an observational study designed to evaluate associations in routine clinical care and not to prove a treatment effect.

Conditions studied

Obesity & Overweight
Diabetes Mellitus Type 2
Neoplasms

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In context

Obesity

6,296 studies on the registry are indexed under Obesity; 1,695 are open to participants now.

This study's enrollment of 203,424 is above the median of 135 across 1,283 observational studies indexed under Obesity.

Browse Obesity studies →

Lead sponsor

Chung Shan Medical University is the lead sponsor of 124 studies on the registry; 26 are open to participants now.

Counted across the registry records on this site, refreshed daily.

Who can participate

Ages eligible: 18 Years and older
Sexes eligible: All
Accepts healthy volunteers: No
Sampling method: Non-probability sample

Study population

Adults will be selected from the TriNetX US Collaborative Network, a distributed database of de-identified electronic health records contributed by participating healthcare organizations across multiple clinical systems and practice settings. The study population consists of adults with obesity and type 2 diabetes who received routine clinical care in this network and were identified through diagnosis records, body mass index data, and medication prescribing data. The overall study population was classified into two mutually exclusive cohorts according to pre-diagnosis GLP-1 receptor agonist use: participants with pre-diagnosis GLP-1 receptor agonist use and participants without pre-diagnosis GLP-1 receptor agonist use. Comparator-specific propensity score-matched cohorts for GLP-1 RA versus SGLT2 inhibitors, DPP-4 inhibitors, sulfonylureas, metformin, and usual care were defined within this source population for prespecified pairwise outcome analyses.

Inclusion criteria

Adults aged 18 years or older
BMI ≥27 kg/m2, or diagnosis codes consistent with obesity
Type 2 diabetes mellitus
Initiation of a glucose-lowering medication before obesity-associated cancer diagnosis
Incident obesity-associated cancer diagnosed after medication initiation
No dispensing of the study drug class during the 6-month washout period before the first qualifying prescription

Exclusion criteria

Exclusion Criteria:

Type 1 diabetes mellitus, Other specified diabetes types that are not type 2 diabetes
Human immunodeficiency virus infection
End-stage renal disease
Prior bariatric surgery
Prior organ transplantation
Transplant-related complications
Any use of tirzepatide before cohort entry

Study design

Observational model: Cohort
Time perspective: Retrospective
Enrollment: 203,424 participants (actual)
Patient registry: No

Groups and cohorts

GLP-1 RA
Adults with obesity and type 2 diabetes who developed an obesity-associated cancer after initiating a GLP-1 receptor agonist before cancer diagnosis. This cohort served as the GLP-1 RA exposure cohort in the overall study population and represents the unique participants with pre-diagnosis GLP-1 receptor agonist use.
Usual Care Without GLP-1 RA
Adults with obesity and type 2 diabetes who developed an obesity-associated cancer and had no GLP-1 receptor agonist prescriptions before cancer diagnosis. This cohort served as the non-GLP-1 RA comparator cohort in the overall study population. Participants could receive routine clinical care, including other non-GLP-1 RA glucose-lowering medications. This cohort represents the unique participants without pre-diagnosis GLP-1 receptor agonist use.

What researchers measure

Primary outcomes

All-cause Mortality (Comparison 1)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause Mortality (Comparison 2)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause Mortality (Comparison 3)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause Mortality (Comparison 4)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause Mortality (Comparison 5)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Time frame: From obesity-associated cancer diagnosis through 36 months

Secondary outcomes

Inpatient (Comparison 1)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 2)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 3)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 4)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 5)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 1)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 2)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 3)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 4)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 5)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 1)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 2)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 3)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 4)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 5)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 1)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 2)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 3)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 4)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 5)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Time frame: From obesity-associated cancer diagnosis through 36 months

Results

Posted Aug 17, 2026

Limitations and caveats

This retrospective observational target-trial emulation is subject to residual confounding, misclassification, and missing or incomplete electronic health record data. Treatment strategies were not randomly assigned, and propensity score matching was performed separately for each pairwise comparison. Outcome ascertainment may have been affected by variable documentation and follow-up in routine clinical practice.

Participant flow

Participants were retrospectively identified from the TriNetX US Collaborative Network using de-identified electronic health records. Eligible adults with obesity and type 2 diabetes who initiated glucose-lowering therapy between January 1, 2018 and October 31, 2025 and subsequently developed an obesity-associated cancer were included based on prespecified eligibility criteria.

Participant flow — Overall Study
Milestone	GLP-1 RA	Usual Care Without GLP-1 RA
Started	27208	176216
Matched into comparison 1 (glp-1 ra without sglt2i vs sglt2i)	12193	12193
Matched into comparison 2 (glp-1 ra without dpp-4i vs dpp-4i)	11154	11154
Matched into comparison 3 (glp-1 ra without sulfonylureas vs sulfonylureas)	14072	14072
Matched into comparison 4 (glp-1 ra without metformin vs metformin)	9819	9819
Matched into comparison 5 (glp-1 ra vs usual care)	26433	26433
Completed	27208	176216
Not completed	0	0

Outcome measures

PrimaryAll-cause Mortality (Comparison 1)

All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

All-cause Mortality (Comparison 1)
participants with event	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)
All-cause Mortality (Comparison 1)	876	1233

SecondaryInpatient (Comparison 1)

Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Inpatient (Comparison 1)
participants with event	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)
Inpatient (Comparison 1)	874	952

SecondaryInpatient (Comparison 2)

Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Inpatient (Comparison 2)
participants with event	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)
Inpatient (Comparison 2)	784	1077

SecondaryInpatient (Comparison 3)

Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Inpatient (Comparison 3)
participants with event	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)
Inpatient (Comparison 3)	994	1477

SecondaryInpatient (Comparison 4)

Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Inpatient (Comparison 4)
participants with event	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)
Inpatient (Comparison 4)	622	865

PrimaryAll-cause Mortality (Comparison 2)

All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

All-cause Mortality (Comparison 2)
participants with event	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)
All-cause Mortality (Comparison 2)	815	1364

SecondaryInpatient (Comparison 5)

Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Inpatient (Comparison 5)
participants with event	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)
Inpatient (Comparison 5)	1896	2522

SecondaryPericardial Effusion (Comparison 1)

Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pericardial Effusion (Comparison 1)
participants with event	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)
Pericardial Effusion (Comparison 1)	107	128

SecondaryPericardial Effusion (Comparison 2)

Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pericardial Effusion (Comparison 2)
participants with event	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)
Pericardial Effusion (Comparison 2)	105	133

SecondaryPericardial Effusion (Comparison 3)

Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pericardial Effusion (Comparison 3)
participants with event	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)
Pericardial Effusion (Comparison 3)	113	161

PrimaryAll-cause Mortality (Comparison 3)

All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

All-cause Mortality (Comparison 3)
participants with event	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)
All-cause Mortality (Comparison 3)	883	1736

SecondaryPericardial Effusion (Comparison 4)

Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pericardial Effusion (Comparison 4)
participants with event	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)
Pericardial Effusion (Comparison 4)	69	82

SecondaryPericardial Effusion (Comparison 5)

Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pericardial Effusion (Comparison 5)
participants with event	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)
Pericardial Effusion (Comparison 5)	218	261

SecondaryPulmonary Embolism (Comparison 1)

Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pulmonary Embolism (Comparison 1)
participants with event	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)
Pulmonary Embolism (Comparison 1)	192	217

SecondaryPulmonary Embolism (Comparison 2)

Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pulmonary Embolism (Comparison 2)
participants with event	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)
Pulmonary Embolism (Comparison 2)	163	216

PrimaryAll-cause Mortality (Comparison 4)

All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

All-cause Mortality (Comparison 4)
participants with event	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)
All-cause Mortality (Comparison 4)	631	871

SecondaryPulmonary Embolism (Comparison 3)

Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pulmonary Embolism (Comparison 3)
participants with event	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)
Pulmonary Embolism (Comparison 3)	220	281

SecondaryPulmonary Embolism (Comparison 4)

Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pulmonary Embolism (Comparison 4)
participants with event	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)
Pulmonary Embolism (Comparison 4)	123	163

SecondaryPulmonary Embolism (Comparison 5)

Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Pulmonary Embolism (Comparison 5)
participants with event	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)
Pulmonary Embolism (Comparison 5)	385	506

SecondarySepsis (Comparison 1)

Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Sepsis (Comparison 1)
participants with event	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)
Sepsis (Comparison 1)	453	553

PrimaryAll-cause Mortality (Comparison 5)

All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

All-cause Mortality (Comparison 5)
participants with event	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)
All-cause Mortality (Comparison 5)	1584	2660

SecondarySepsis (Comparison 2)

Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Sepsis (Comparison 2)
participants with event	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)
Sepsis (Comparison 2)	414	590

SecondarySepsis (Comparison 3)

Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Sepsis (Comparison 3)
participants with event	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)
Sepsis (Comparison 3)	506	743

SecondarySepsis (Comparison 4)

Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Sepsis (Comparison 4)
participants with event	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)
Sepsis (Comparison 4)	320	406

SecondarySepsis (Comparison 5)

Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.

Time frame:: From obesity-associated cancer diagnosis through 36 months
Reported as:: Number · participants with event

Sepsis (Comparison 5)
participants with event	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)
Sepsis (Comparison 5)	904	1213

Adverse events

Collected over From index date through 36 months of follow-up. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
Group	Deaths	Serious	Other
GLP-1 RA Without History of SGLT2i (Comparison 1)	876/12,060 (7.3%)	—	—
SGLT2i (Comparison 1)	1,233/12,125 (10.2%)	—	—
GLP-1 RA Without History of DPP-4i (Comparison 2)	815/10,922 (7.5%)	—	—
DPP-4i (Comparison 2)	1,364/10,984 (12.4%)	—	—
GLP-1 RA Without History of Sulfonylureas (Comparison 3)	883/13,801 (6.4%)	—	—
Sulfonylureas (Comparison 3)	1,736/13,819 (12.6%)	—	—
GLP-1 RA Without History of Metformin (Comparison 4)	631/9,590 (6.6%)	—	—
Metformin (Comparison 4)	871/9,645 (9%)	—	—
GLP-1 RA (Comparison 5)	1,584/25,910 (6.1%)	—	—
Usual Care (Comparison 5)	2,660/25,920 (10.3%)	—	—

Baseline characteristics

Baseline characteristics are reported separately for each prespecified pairwise propensity score-matched comparison. For each baseline measure corresponding to a given comparison, data are provided only for the two arms included in that comparison; the remaining arms are assigned 0 participants analyzed in order to avoid counting participants more than once within a row.

Age, Customized
Age, Customized(Participants)	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)	Total
<65 years (Comparison 1)	4629	4636	0	0	0	0	0	0	0	0	9265
≥65 years (Comparison 1)	7564	7557	0	0	0	0	0	0	0	0	15121
<65 years (Comparison 2)	0	0	3272	3284	0	0	0	0	0	0	6556
≥65 years (Comparison 2)	0	0	7882	7870	0	0	0	0	0	0	15752
<65 years (Comparison 3)	0	0	0	0	5148	5193	0	0	0	0	10341
≥65 years (Comparison 3)	0	0	0	0	8924	8879	0	0	0	0	17803
<65 years (Comparison 4)	0	0	0	0	0	0	4132	4065	0	0	8197
≥65 years (Comparison 4)	0	0	0	0	0	0	5687	5754	0	0	11441
<65 years (Comparison 5)	0	0	0	0	0	0	0	0	12066	12085	24151
≥65 years (Comparison 5)	0	0	0	0	0	0	0	0	14367	14348	28715

Sex/Gender, Customized
Sex/Gender, Customized(Participants)	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)	Total
Male (Comparison 1)	3534	3508	0	0	0	0	0	0	0	0	7042
Female (Comparison 1)	8651	8679	0	0	0	0	0	0	0	0	17330
Unknown or Not Reported (Comparison 1)	8	6	0	0	0	0	0	0	0	0	14
Male (Comparison 2)	0	0	3546	3534	0	0	0	0	0	0	7080
Female (Comparison 2)	0	0	7605	7615	0	0	0	0	0	0	15220
Unknown or Not Reported (Comparison 2)	0	0	3	5	0	0	0	0	0	0	8
Male (Comparison 3)	0	0	0	0	4205	4239	0	0	0	0	8444
Female (Comparison 3)	0	0	0	0	9863	9827	0	0	0	0	19690
Unknown or Not Reported (Comparison 3)	0	0	0	0	4	6	0	0	0	0	10
Male (Comparison 4)	0	0	0	0	0	0	2484	2481	0	0	4965
Female (Comparison 4)	0	0	0	0	0	0	7327	7329	0	0	14656
Unknown or Not Reported (Comparison 4)	0	0	0	0	0	0	8	9	0	0	17
Male (Comparison 5)	0	0	0	0	0	0	0	0	6883	7109	13992
Female (Comparison 5)	0	0	0	0	0	0	0	0	19532	19307	38839
Unknown or Not Reported (Comparison 5)	0	0	0	0	0	0	0	0	18	17	35

Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)	Total
Comparison 1 — Hispanic or Latino	1007	1024	0	0	0	0	0	0	0	0	2031
Comparison 1 — Not Hispanic or Latino	9245	9251	0	0	0	0	0	0	0	0	18496
Comparison 1 — Unknown or Not Reported	1941	1918	0	0	0	0	0	0	0	0	3859
Comparison 2 — Hispanic or Latino	0	0	1023	1012	0	0	0	0	0	0	2035
Comparison 2 — Not Hispanic or Latino	0	0	8463	8434	0	0	0	0	0	0	16897
Comparison 2 — Unknown or Not Reported	0	0	1668	1708	0	0	0	0	0	0	3376
Comparison 3 — Hispanic or Latino	0	0	0	0	1154	1147	0	0	0	0	2301
Comparison 3 — Not Hispanic or Latino	0	0	0	0	10605	10638	0	0	0	0	21243
Comparison 3 — Unknown or Not Reported	0	0	0	0	2313	2287	0	0	0	0	4600
Comparison 4 — Hispanic or Latino	0	0	0	0	0	0	687	667	0	0	1354
Comparison 4 — Not Hispanic or Latino	0	0	0	0	0	0	7239	7310	0	0	14549
Comparison 4 — Unknown or Not Reported	0	0	0	0	0	0	1893	1842	0	0	3735
Comparison 5 — Hispanic or Latino	0	0	0	0	0	0	0	0	2294	2217	4511
Comparison 5 — Not Hispanic or Latino	0	0	0	0	0	0	0	0	19784	19926	39710
Comparison 5 — Unknown or Not Reported	0	0	0	0	0	0	0	0	4355	4290	8645

HbA1c ≥7%
HbA1c ≥7%(Participants)	GLP-1 RA Without History of SGLT2i (Comparison 1)	SGLT2i (Comparison 1)	GLP-1 RA Without History of DPP-4i (Comparison 2)	DPP-4i (Comparison 2)	GLP-1 RA Without History of Sulfonylureas (Comparison 3)	Sulfonylureas (Comparison 3)	GLP-1 RA Without History of Metformin (Comparison 4)	Metformin (Comparison 4)	GLP-1 RA (Comparison 5)	Usual Care (Comparison 5)	Total
HbA1c ≥7% (Comparison 1)	7230	7232	0	0	0	0	0	0	0	0	14462
HbA1c ≥7% (Comparison 2)	0	0	7048	6981	0	0	0	0	0	0	14029
HbA1c ≥7% (Comparison 3)	0	0	0	0	8709	8673	0	0	0	0	17382
HbA1c ≥7% (Comparison 4)	0	0	0	0	0	0	5300	5255	0	0	10555
HbA1c ≥7% (Comparison 5)	0	0	0	0	0	0	0	0	16877	17036	33913

Study locations

1 site

Chung Shan Medical University Hospital
Taichung, Taichung City 402, Taiwan

References and documents

Publications

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Wong CK, Drucker DJ. Antiinflammatory actions of glucagon-like peptide-1-based therapies beyond metabolic benefits. J Clin Invest. 2025 Nov 3;135(21):e194751. doi: 10.1172/JCI194751. eCollection 2025 Nov 3. PubMed 41178710 ↗
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Chen B, Yu X, Horvath-Diano C, Ortuno MJ, Tschop MH, Jastreboff AM, Schneeberger M. GLP-1 programs the neurovascular landscape. Cell Metab. 2024 Oct 1;36(10):2173-2189. doi: 10.1016/j.cmet.2024.09.003. PubMed 39357509 ↗
Pfaffenlehner M, Behrens M, Zoller D, Ungethum K, Gunther K, Rucker V, Reese JP, Heuschmann P, Kesselmeier M, Remo F, Scherag A, Binder H, Binder N; EVA4MII project. Methodological challenges using routine clinical care data for real-world evidence: a rapid review utilizing a systematic literature search and focus group discussion. BMC Med Res Methodol. 2025 Jan 14;25(1):8. doi: 10.1186/s12874-024-02440-x. PubMed 39810151 ↗
Zhou L, Duanmu W, Tan F, Gu X, Che H, Yin W. Information pharmacists assist in the construction of GLP-1RA prescription review rules in a tertiary hospital in China. BMC Health Serv Res. 2025 Oct 1;25(1):1276. doi: 10.1186/s12913-025-13377-2. PubMed 41034888 ↗
Arroyo V, Angeli P, Moreau R, Jalan R, Claria J, Trebicka J, Fernandez J, Gustot T, Caraceni P, Bernardi M; investigators from the EASL-CLIF Consortium, Grifols Chair and European Foundation for the Study of Chronic Liver Failure (EF-Clif). The systemic inflammation hypothesis: Towards a new paradigm of acute decompensation and multiorgan failure in cirrhosis. J Hepatol. 2021 Mar;74(3):670-685. doi: 10.1016/j.jhep.2020.11.048. Epub 2020 Dec 7. PubMed 33301825 ↗
Liu C, Liu T, Zhang Q, Song M, Zhang Q, Shi J, Deng L, Chen Y, Zheng X, Lin S, Wang Z, Xie H, Chen S, Wu S, Shi H. Temporal relationship between inflammation and metabolic disorders and their impact on cancer risk. J Glob Health. 2024 Feb 16;14:04041. doi: 10.7189/jogh.14.04041. PubMed 38386717 ↗
Silverii GA, Marinelli C, Bettarini C, Del Vescovo GG, Monami M, Mannucci E. GLP-1 receptor agonists and the risk for cancer: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2025 Aug;27(8):4454-4468. doi: 10.1111/dom.16489. Epub 2025 May 29. PubMed 40437949 ↗
Valencia-Rincon E, Rai R, Chandra V, Wellberg EA. GLP-1 receptor agonists and cancer: current clinical evidence and translational opportunities for preclinical research. J Clin Invest. 2025 Nov 3;135(21):e194743. doi: 10.1172/JCI194743. eCollection 2025 Nov 3. PubMed 41178720 ↗
Wang L, Xu R, Kaelber DC, Berger NA. Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes. JAMA Netw Open. 2024 Jul 1;7(7):e2421305. doi: 10.1001/jamanetworkopen.2024.21305. PubMed 38967919 ↗
Ko A, Chang YC, Bahar F, Wang TH, Xanthavanij N, Yu CC, Hsieh RJ, See XY, Lo SW, Song J, Hsia YP, Chiang CH, Xu X, Lin S, Chiang CH. Risk for Cancer With Glucagon-Like Peptide-1 Receptor Agonists and Dual Agonists : A Systematic Review and Meta-analysis. Ann Intern Med. 2026 Feb;179(2):216-229. doi: 10.7326/ANNALS-25-02237. Epub 2025 Dec 9. PubMed 41359966 ↗
Huang YN, Tsou MY, Li PH, Chen JC, Liu YL, Meyerowitz-Katz G, Tsai TH, Su PH. Effectiveness of Pre-Transplant Dual GLP-1 Receptor Agonist and SGLT2 Inhibitor Therapy on All-Cause Mortality in Organ Transplantation Candidates with Obesity and Type 2 Diabetes: a Target-Trial Emulation. Adv Sci (Weinh). 2026 Feb;13(11):e18813. doi: 10.1002/advs.202518813. Epub 2025 Dec 12. PubMed 41387113 ↗
Dib BN, Swanson SA. Emulating a Target Trial Using Observational Data. JAMA Intern Med. 2025 Apr 1;185(4):459-460. doi: 10.1001/jamainternmed.2024.8129. PubMed 39992643 ↗
Hernan MA, Robins JM. Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available. Am J Epidemiol. 2016 Apr 15;183(8):758-64. doi: 10.1093/aje/kwv254. Epub 2016 Mar 18. PubMed 26994063 ↗
Cashin AG, Hansford HJ, Hernan MA, Swanson SA, Lee H, Jones MD, Dahabreh IJ, Dickerman BA, Egger M, Garcia-Albeniz X, Golub RM, Islam N, Lodi S, Moreno-Betancur M, Pearson SA, Schneeweiss S, Sharp MK, Sterne JAC, Stuart EA, McAuley JH. Transparent reporting of observational studies emulating a target trial: the TARGET Statement. BMJ. 2025 Sep 3;390:e087179. doi: 10.1136/bmj-2025-087179. PubMed 40903028 ↗
Yadav K, Lewis RJ. Immortal Time Bias in Observational Studies. JAMA. 2021 Feb 16;325(7):686-687. doi: 10.1001/jama.2020.9151. No abstract available. PubMed 33591334 ↗
Hicks B, Kaye JA, Azoulay L, Kristensen KB, Habel LA, Pottegard A. The application of lag times in cancer pharmacoepidemiology: a narrative review. Ann Epidemiol. 2023 Aug;84:25-32. doi: 10.1016/j.annepidem.2023.05.004. Epub 2023 May 9. PubMed 37169040 ↗
Zuo H, Yu L, Campbell SM, Yamamoto SS, Yuan Y. The implementation of target trial emulation for causal inference: a scoping review. J Clin Epidemiol. 2023 Oct;162:29-37. doi: 10.1016/j.jclinepi.2023.08.003. Epub 2023 Aug 9. PubMed 37562726 ↗
Enserro DM, Gunn HJ, Elsaid MI, Duan F, Pugh SL. Challenges to and considerations of designing cancer prevention trials. J Natl Cancer Inst Monogr. 2025 Mar 1;2025(68):49-55. doi: 10.1093/jncimonographs/lgae044. PubMed 39989045 ↗
Hernan MA, Dahabreh IJ, Dickerman BA, Swanson SA. The Target Trial Framework for Causal Inference From Observational Data: Why and When Is It Helpful? Ann Intern Med. 2025 Mar;178(3):402-407. doi: 10.7326/ANNALS-24-01871. Epub 2025 Feb 18. PubMed 39961105 ↗
Soni PD, Hartman HE, Dess RT, Abugharib A, Allen SG, Feng FY, Zietman AL, Jagsi R, Schipper MJ, Spratt DE. Comparison of Population-Based Observational Studies With Randomized Trials in Oncology. J Clin Oncol. 2019 May 10;37(14):1209-1216. doi: 10.1200/JCO.18.01074. Epub 2019 Mar 21. PubMed 30897037 ↗
Chan SH, Li PY, Li PH, Lin YJ, Wang WH, Huang YN, Chen JY. GLP-1 receptor agonist use during immune checkpoint inhibitor therapy is associated with mortality and Immune-Related adverse events across cancer types in People with type 2 Diabetes: A Target-Trial emulation. Diabetes Res Clin Pract. 2026 Jan;231:113073. doi: 10.1016/j.diabres.2025.113073. Epub 2025 Dec 24. PubMed 41453566 ↗
Dai H, Li Y, Lee YA, Lu Y, George TJ, Donahoo WT, Lee KP, Nakshatri H, Allen J, Guo Y, Sun RC, Guo J, Bian J. GLP-1 Receptor Agonists and Cancer Risk in Adults With Obesity. JAMA Oncol. 2025 Oct 1;11(10):1186-1193. doi: 10.1001/jamaoncol.2025.2681. PubMed 40839273 ↗
Drucker DJ. GLP-1-based therapies for diabetes, obesity and beyond. Nat Rev Drug Discov. 2025 Aug;24(8):631-650. doi: 10.1038/s41573-025-01183-8. Epub 2025 Apr 25. PubMed 40281304 ↗
Huang YN, Liao WL, Huang JY, Lin YJ, Yang SF, Huang CC, Wang CH, Su PH. Long-term safety and efficacy of glucagon-like peptide-1 receptor agonists in individuals with obesity and without type 2 diabetes: A global retrospective cohort study. Diabetes Obes Metab. 2024 Nov;26(11):5222-5232. doi: 10.1111/dom.15869. Epub 2024 Aug 22. PubMed 39171569 ↗
Luconi M, Cantini G, Crescioli C. Repurposing glucose-lowering drugs for cancer therapy. Trends Cancer. 2025 Jul;11(7):691-710. doi: 10.1016/j.trecan.2025.04.010. Epub 2025 May 15. PubMed 40374399 ↗
Chan JCN, Lim LL, Wareham NJ, Shaw JE, Orchard TJ, Zhang P, Lau ESH, Eliasson B, Kong APS, Ezzati M, Aguilar-Salinas CA, McGill M, Levitt NS, Ning G, So WY, Adams J, Bracco P, Forouhi NG, Gregory GA, Guo J, Hua X, Klatman EL, Magliano DJ, Ng BP, Ogilvie D, Panter J, Pavkov M, Shao H, Unwin N, White M, Wou C, Ma RCW, Schmidt MI, Ramachandran A, Seino Y, Bennett PH, Oldenburg B, Gagliardino JJ, Luk AOY, Clarke PM, Ogle GD, Davies MJ, Holman RR, Gregg EW. The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet. 2021 Dec 19;396(10267):2019-2082. doi: 10.1016/S0140-6736(20)32374-6. Epub 2020 Nov 12. No abstract available. PubMed 33189186 ↗
Kang C, LeRoith D, Gallagher EJ. Diabetes, Obesity, and Breast Cancer. Endocrinology. 2018 Nov 1;159(11):3801-3812. doi: 10.1210/en.2018-00574. PubMed 30215698 ↗
Perry RJ, Shulman GI. Mechanistic Links between Obesity, Insulin, and Cancer. Trends Cancer. 2020 Feb;6(2):75-78. doi: 10.1016/j.trecan.2019.12.003. Epub 2020 Jan 14. PubMed 32061306 ↗
Zullig LL, Sung AD, Khouri MG, Jazowski S, Shah NP, Sitlinger A, Blalock DV, Whitney C, Kikuchi R, Bosworth HB, Crowley MJ, Goldstein KM, Klem I, Oeffinger KC, Dent S. Cardiometabolic Comorbidities in Cancer Survivors: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol. 2022 Jun 21;4(2):149-165. doi: 10.1016/j.jaccao.2022.03.005. eCollection 2022 Jun. PubMed 35818559 ↗
Rask-Andersen M, Ivansson E, Hoglund J, Ek WE, Karlsson T, Johansson A. Adiposity and sex-specific cancer risk. Cancer Cell. 2023 Jun 12;41(6):1186-1197.e4. doi: 10.1016/j.ccell.2023.05.010. PubMed 37311415 ↗
GBD 2019 Cancer Risk Factors Collaborators. The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022 Aug 20;400(10352):563-591. doi: 10.1016/S0140-6736(22)01438-6. PubMed 35988567 ↗

Study documents

Protocol and statistical analysis plan · Apr 6, 2026

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — Individual participant data will not be shared. This retrospective observational study uses de-identified electronic health record data from the TriNetX US Collaborative Network. Access to individual-level data is restricted by data use agreements, institutional policies, and privacy protections. Researchers who meet eligibility requirements may obtain access to similar de-identified data through a TriNetX license or through participating institutions.

Updates

Tracking since Sep 25, 2026

No changes since tracking began. The registry record was last updated on Aug 17, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗

Registry details

Key details

Study ID: NCT07513259
Lead sponsor: Chung Shan Medical University
Collaborators: National Science and Technology Council, Taiwan
Responsible party: Yu-Nan Huang (Assistant Professor/Research Fellow, Chung Shan Medical University) — Principal investigator
First posted: Apr 7, 2026
Start date: Jan 1, 2018
Primary completion: Oct 31, 2025
Completion: Oct 31, 2025
Results posted: Aug 17, 2026
Last update: Aug 17, 2026

Oversight

Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No

View the source record on ClinicalTrials.gov ↗

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