The Abrahami and colleagues report that use of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (collectively called incretins) “might be they are associated with an increased risk of cholangiocarcinoma in adults with type 2 diabetes.” If incretins are associated only indirectly with cholangiocarcinoma, people with diabetes would not have a problem. The issue for patients, doctors, and regulators are establishing for certain whether these drugs cause cholangiocarcinoma, a conclusion that this single observational study cannot support. Abrahami and colleagues’ well-executed pharmacoepidemiological study shows that people who take incretins have higher rates of cholangiocarcinoma than people who do not take incretins.
There is one possibility, that non-incretin treatments prevent cholangiocarcinoma—an interpretation the authors discount. Another…
