Evidence map›Paper›PMID 41469686›Full record

ArticleBMC medicine2025

Association of GLP-1 receptor agonists with herpes risks in diabetes mellitus: a target trial emulation.

Chi-Hsien Huang, I-Hui Chiang, I-Cheng Lu, Po-Hsuan Lai, Pei-Lun Liao, Jing-Yang Huang, Ming-Ta Hsieh, Chi-Wei Lin, I-Ting Liu, James Cheng-Chung Wei

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Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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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

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Chi-Hsien HuangDepartment of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan.
I-Hui ChiangDepartment of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan.
I-Cheng LuDepartment of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan.
Po-Hsuan LaiDepartment of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan.
Pei-Lun LiaoCenter for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
Jing-Yang HuangCenter for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
Ming-Ta HsiehDepartment of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan.
Chi-Wei LinDepartment of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan.
I-Ting Liu *Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan. claireliu627@gmail.com.
James Cheng-Chung Wei *Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. jccwei@gmail.com.ORCID http://orcid.org/0000-0002-1235-0679

Funding

E-Da Hospital EDAHP114016, EDAHS114019, EDAHJ113006, EDAHJ114008National Science and Technology Council, Taiwan NSTC 112‑2314‑B‑650‑001‑MY3
6 · The paper itself

Abstract

backgroundGLP-1 receptor agonists (GLP-1RA) are effective for glycemic control and cardiometabolic outcomes, but their infectious safety, particularly regarding herpes simplex virus (HSV) and herpes zoster (HZ), is underexplored. This study evaluated the association between GLP-1RA therapy and risks of HSV and HZ infections in patients with DM, compared to sodium-glucose co-transporter-2 inhibitors (SGLT-2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i).

methodsWe conducted a retrospective cohort analysis using target trial emulation principles on de-identified electronic health records from the TriNetX U.S. Network (2015-2022). Adults aged ≥ 18 years with diabetes prescribed biguanides were included. New users of GLP-1RA were compared to DPP-4i users in the first cohort and SGLT-2i users in the second cohort. Primary outcomes were HSV and HZ incidence, analyzed with Kaplan-Meier curves and Cox proportional hazards models.

resultsAmong 95,190 GLP-1RA vs. DPP-4i pairs and 82,789 GLP-1RA vs. SGLT-2i pairs, GLP-1RA therapy was associated with higher risks of HSV (HR = 1.387, 95% CI = 1.249-1.539) and HZ (HR = 1.294, 95% CI = 1.203-1.392) compared to DPP-4i and HSV (HR = 1.277, 95% CI = 1.132-1.442) and HZ (HR = 1.18, 95% CI = 1.085-1.284) compared to SGLT-2i. Younger patients (18-50 years) on GLP-1RAs had elevated risks for HSV (HR = 1.632) and HZ (HR = 1.553). Female GLP-1RA users showed increased HSV risk (HR = 1.51), and poorly controlled patients (HbA1c ≥ 7%) had higher HSV risks (HR = 1.195). Herpes zoster vaccination mitigated these risks.

conclusionsGLP-1RA use is associated with an increased risk of HSV and HZ infections compared with SGLT-2i or a DPP-4i use, especially in younger, female, and poorly controlled T2DM patients. Vaccination against herpes zoster is essential in mitigating these risks.

Indexed as

Diabetes MellitusDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHerpes SimplexHerpes ZosterHypoglycemic AgentsAdolescentAdultAgedDipeptidyl-Peptidase IV InhibitorsFemaleHumansMaleMiddle AgedRetrospective StudiesSodium-Glucose Transporter 2 InhibitorsDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsGLP-1 receptor agonistsHerpes simplex infectionHerpes zosterHerpes zoster vaccination

Identifiers

PMID41469686
PMCPMC12964619

What Socratic holds

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LicenceCC BY-NC-ND
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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.