GLP-1s Plus Progestins Tied to Lower Endometrial Cancer Risk

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A new study found that among women with endometrial hyperplasia or benign uterine pathology, the addition of a GLP-1 receptor agonist (RA) to progestin therapy was associated with a two-thirds lower risk for endometrial cancer than either progestins alone or progestins plus metformin.

Why it matters

Progestins are the standard therapy for endometrial hyperplasia and abnormal uterine bleeding, but there has been limited data on whether combining GLP-1 RAs with progestins can reduce the risk of endometrial cancer in patients with precancerous or benign uterine disease.

The details

Researchers analyzed data from 444,820 women with endometrial hyperplasia or benign uterine pathology who received progestins between May 2005 and December 2022. After propensity score matching, the study found that endometrial cancer developed in 0.5% of patients who received GLP-1 plus progestins, compared to 1.8% of those who received progestins only - a 66% lower risk. The protective association held across subgroups based on progestin route, baseline risk, BMI, and age.

• The study analyzed data from May 2005 to December 2022.
• The primary outcome was the incidence of endometrial cancer, and the secondary outcome was the incidence of hysterectomy.

What they’re saying

What’s next

Further prospective studies and clinical trials are warranted to validate these findings, to explore optimal dosing and duration strategies, and to better elucidate the biological mechanisms of GLP-1 RA.