Evidence mapPaperPMID 41898482Full record

SynthesisInternational journal of molecular sciences2026

Gastric Neoplasm Risk with DPP-4 Inhibitors, GLP-1 Receptor Agonists, and SGLT2 Inhibitors: Network Meta-Analysis of Randomized Trials.

Chao-Ming Hung, Chih-Wei Hsu, Bing-Syuan Zeng, Mein-Woei Suen, Jiann-Jy Chen, Bing-Yan Zeng, Andre F Carvalho, Brendon Stubbs, Yen-Wen Chen, Tien-Yu Chen and 5 more

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Chao-Ming HungDivision of General Surgery, Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 824, Taiwan.
Chih-Wei HsuDepartment of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.ORCID 0000-0002-8650-4060
Bing-Syuan ZengDepartment of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung 824, Taiwan.
Mein-Woei SuenDepartment of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.ORCID 0000-0002-3991-0322
Jiann-Jy ChenProspect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan.
Bing-Yan ZengInstitute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan.
Andre F CarvalhoInnovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC 3216, Australia.
Brendon StubbsDepartment of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London WC2R 2LS, UK.
Yen-Wen ChenProspect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan.
Tien-Yu ChenDepartment of Psychiatry, Tri-Service General Hospital, Taipei 114, Taiwan.ORCID 0000-0001-8462-1311
Shih-Pin HsuSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan.
Hung-Yu WangKaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 802, Taiwan.
Chih-Sung LiangDepartment of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical University, Taipei 114, Taiwan.
Yu-Kang TuInstitute of Health Data Analytics & Statistics, College of Public Health, National Taiwan University, No. 17, Xuzhou Road, Taipei 100, Taiwan.ORCID 0000-0002-2461-474X
Ping-Tao TsengProspect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan.ORCID 0000-0001-5761-7800

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Whether the risk of gastric neoplasm is modified by newer glucose-lowering therapies-dipeptidyl peptidase-4 inhibitors (DPP4is), glucagon-like peptide-1 receptor agonists (GLP1RAs), and sodium-glucose cotransporter 2 inhibitors (SGLT2is)-remains uncertain. Given their global uptake and long-term use in populations already predisposed to malignancy, decision-grade comparative safety evidence is needed. We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) in adults without baseline gastric neoplasms. PubMed, Embase, Cochrane CENTRAL, Web of Science, ClinicalTrials.gov, ClinicalKey, ProQuest, and ScienceDirect were searched from inception to 10 January 2026, without language restrictions. The primary outcome was incident gastric neoplasms (benign or malignant). Random-effects frequentist NMA estimated risk ratios (RRs) with 95% confidence intervals (CIs); Bayesian NMA served as sensitivity analysis. Certainty of evidence was assessed using GRADE adapted for NMA (PROSPERO CRD420261282728). Fifty-two RCTs (171,165 participants; mean age 63.6 years; 36.9% women; mean follow-up 141.8 weeks) were included. At the class level, GLP1RAs were associated with lower gastric neoplasm risk versus controls (RR = 0.51, 95% CI = 0.28-0.92), whereas DPP4is were associated with higher risk (RR = 1.77, 95% CI = 1.09-2.85). These signals persisted in prespecified subgroup analyses among participants with diabetes mellitus, in trials with duration ≥52 weeks (GLP1RA: RR = 0.52, 95% CI = 0.28-0.95; DPP4i: RR = 2.05, 95% CI = 1.19-3.55), and in older populations (age ≥60 years; DPP4i: RR = 2.08, 95% CI = 1.15-3.77). No class showed a significant association in younger participants (<60 years) or shorter trials (<52 weeks). Across available RCT evidence, GLP1RA prescription generally had a relatively lower gastric neoplasm risk than controls. In contrast, among patients with diabetes mellitus receiving longer-term therapy, GLP1RAs may be the preferable option from the perspective of gastric neoplasm risk, while DPP4is warrant heightened vigilance and mechanistic clarification. These findings support improved neoplasms ascertainment in future trials rather than immediate prescribing changes.

Indexed as

Dipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsSodium-Glucose Transporter 2 InhibitorsStomach NeoplasmsDiabetes Mellitus, Type 2FemaleHumansHypoglycemic AgentsRandomized Controlled Trials as TopicRisk FactorsDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitorsdiabetes mellitusDPP-4 inhibitorgastric neoplasmsGLP-1 receptor agonistsemaglutideSGLT2 inhibitor

Identifiers

PMID41898482
PMCPMC13026302

What Socratic holds

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Registered trials

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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.