Evidence map›Paper›PMID 39008852›Full record

ArticleAnnals of internal medicine2024

Glucagon-Like Peptide-1 Receptor Agonists and Risk for Suicidal Ideation and Behaviors in U.S. Older Adults With Type 2 Diabetes : A Target Trial Emulation Study.

Huilin Tang, Ying Lu, William T Donahoo, Hui Shao, Lizheng Shi, Vivian A Fonseca, Yi Guo, Jiang Bian, Jingchuan Guo

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PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  7. Update on clinical heart failure trials.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Huilin TangDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, Florida (H.T., Y.L.).ORCID 0000-0002-5814-6657
Ying LuDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, Florida (H.T., Y.L.).
William T DonahooDivision of Endocrinology, Diabetes and Metabolism, College of Medicine, University of Florida, Gainesville, Florida (W.T.D.).ORCID 0000-0002-2126-860X
Hui ShaoHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia (H.S.).
Lizheng ShiDepartment of Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana (L.S.).ORCID 0000-0002-7827-6766
Vivian A FonsecaSection of Endocrinology and Metabolism, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana (V.A.F.).ORCID 0000-0002-3381-7151
Yi GuoDepartment of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida (Y.G., J.B.).ORCID 0000-0003-0587-4105
Jiang BianDepartment of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida (Y.G., J.B.).ORCID 0000-0002-2238-5429
Jingchuan GuoDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, and Center for Drug Evaluation and Safety, University of Florida, Gainesville, Florida (J.G.).ORCID 0000-0001-9799-2592

Funding

Computational Drug Repurposing for AD/ADRD with Integrative Analysis of Real World Data and Biomedical KnowledgeR01AG076234 · NIA · WEILL MEDICAL COLL OF CORNELL UNIV · PI Jiang Bian, Fei Wang · 2022 to 2026
$3.8M
Supplement of NIDDK R01 newer GLDs and Clinical OutcomesR01DK133465 · NIDDK · UNIVERSITY OF FLORIDA · PI GUO, JINGCHUAN, SHAO, HUI · 2022 to 2025
$2.8M
NIA NIH HHS R01 AG076234NIDDK NIH HHS R01 DK133465
6 · The paper itself

Abstract

backgroundA major concern has recently emerged about a potential link between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and increased risk for suicidal ideation and behaviors based on International Classification of Diseases codes.

objectiveTo investigate the association between GLP-1 RAs, compared with sodium-glucose cotransporter-2 inhibitors (SGLT2is) or dipeptidyl peptidase-4 inhibitors (DPP4is), and risk for suicidal ideation and behaviors in older adults with type 2 diabetes (T2D).

designTwo target trial emulation studies comparing propensity score (PS)-matched cohorts for GLP-1 RAs versus SGLT2is and GLP-1 RAs versus DPP4is.

settingU.S. national Medicare administrative data from January 2017 to December 2020. PATIENTS: Older adults (≥66 years) with T2D; no record of suicidal ideation or behaviors; and a first prescription for a GLP-1 RA, SGLT2i, or DPP4i. MEASUREMENTS: The primary end point was a composite of suicidal ideation and behaviors. New GLP-1 RA users were matched 1:1 on PS to new users of an SGLT2i or DPP4i in each pairwise comparison. A Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% CIs within matched groups.

resultsThis study included 21 807 pairs of patients treated with a GLP-1 RA versus an SGLT2i and 21 402 pairs of patients treated with a GLP-1 RA versus a DPP4i. The HR of suicidal ideation and behaviors associated with GLP-1 RAs relative to SGLT2is was 1.07 (95% CI, 0.80 to 1.45; rate difference, 0.16 [CI, -0.53 to 0.86] per 1000 person-years); the HR relative to DPP4is was 0.94 (CI, 0.71 to 1.24; rate difference, -0.18 [CI, -0.92 to 0.57] per 1000 person-years). LIMITATIONS: Low event rate; imprecise estimates; unmeasured confounders, such as body mass index; and potential misclassification of outcomes.

conclusionAmong Medicare beneficiaries with T2D, this study found no clear increased risk for suicidal ideation and behaviors with GLP-1 RAs, although estimates were imprecise and a modest adverse risk could not be ruled out. PRIMARY FUNDING SOURCE: American Foundation for Pharmaceutical Education, Pharmaceutical Research and Manufacturers of America Foundation, National Institute on Aging, and National Institute of Diabetes and Digestive and Kidney Diseases.

Indexed as

Diabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsSuicidal IdeationAgedAged, 80 and overFemaleHumansHypoglycemic AgentsMaleMedicarePropensity ScoreRisk FactorsSodium-Glucose Transporter 2 InhibitorsUnited StatesDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID39008852
PMCPMC12132802

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.