Thyroid Cancer Red Flag: FDA Adverse Reporting Data Analysis Shows Alerts on Semaglutide, Tirzepatide Use

Published in Endocrinology, Diabetes & Metabolism, the study sheds light on the possible association between glucagon-like peptide-1 (GLP-1) receptor agonists and an elevated risk of thyroid cancer. These medications—commonly prescribed for obesity and type 2 diabetes—have gained immense popularity in recent years. However, questions about their long-term safety continue to surface, particularly concerning thyroid health.

“These findings highlight the need for ongoing research and vigilant safety monitoring when using these medications for managing obesity,” the researchers reported.

GLP-1 receptor agonists such as semaglutide (Ozempic and Rybelsus) and Dual GIP &GLP-1 Receptor Agonist tirzepatide (Mounjaro) have been widely adopted for weight-loss management due to their efficacy in reducing appetite and promoting weight reduction. Despite their growing clinical use, researchers have noted emerging concerns about their potential association with thyroid malignancies, prompting this comprehensive safety evaluation.

Against the above background, Christophe Abi Zeid Daou from the Department of Otolaryngology and Head and Neck Surgery at the American University of Beirut Medical Center, Lebanon, and colleagues aimed to explore the potential link between thyroid cancer and weight-loss medications.

For this purpose, the researchers reviewed adverse event reports recorded in the FAERS database from 2004 through the first quarter of 2024. To assess the strength of the associations, they conducted a disproportionality analysis—a statistical approach used in pharmacovigilance studies to detect signals of potential drug-related risks. Reporting odds ratios (RORs) were calculated to quantify the likelihood of thyroid cancer events associated with various weight-loss and anti-diabetic medications.

The following were the key findings of the study:

• Semaglutide was linked to a significantly higher risk of thyroid cancer (ROR = 7.61).
• Dulaglutide also showed a notable association with thyroid cancer (ROR = 3.59).
• Liraglutide demonstrated the strongest association among the drugs studied (ROR = 15.59).
• Tirzepatide was associated with an elevated risk of thyroid cancer (ROR = 2.09).
• Metformin showed a weak inverse association, potentially indicating a protective effect (ROR = 0.588).
• No significant associations with thyroid cancer were observed for topiramate, dapagliflozin, or insulin glargine.

While the findings offer valuable insights into possible safety concerns, the authors emphasized the limitations of the FAERS database, which relies on voluntary and spontaneous reporting and lacks a control group—factors that prevent drawing definitive causal conclusions. Nonetheless, the study highlights a potential safety signal that warrants further investigation.

“The study calls for ongoing safety monitoring and patient counselling when prescribing these medications, emphasizing the importance of informed clinical decisions and continued research into the long-term effects of weight-loss therapies,” the researchers concluded.

Reference:

Abi Zeid Daou C, Aboul Hosn O, Ghzayel L, Mourad M. Exploring Connections Between Weight-Loss Medications and Thyroid Cancer: A Look at the FDA Adverse Event Reporting System Database. Endocrinol Diabetes Metab. 2025 Mar;8(2):e70038. doi: 10.1002/edm2.70038. PMID: 40055991; PMCID: PMC11889434.