Obesity & OverweightNCT07513259

Pre-Diagnosis GLP-1 Receptor Agonist Use and Post-Cancer Mortality in Adults With Obesity and Type 2 Diabetes

An observational study of Obesity & Overweight and Diabetes Mellitus Type 2, run by Chung Shan Medical University at 1 site in Taiwan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

Who is it for?: Ages 18 years and older
Conditions the study is for: Obesity & Overweight, Diabetes Mellitus Type 2, Neoplasms
How many people: 203,424 participants
Where: 1 siteTaiwan
Study dates: 1 Jan 2018to 31 Oct 2025
Phase: Observational
Are there results?: Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

Ages 18 years and older
All sexes
No healthy volunteers
Adult, Older adult

Study population: Adults will be selected from the TriNetX US Collaborative Network, a distributed database of de-identified electronic health records contributed by participating healthcare organizations across multiple clinical systems and practice settings. The study population consists of adults with obesity and type 2 diabetes who received routine clinical care in this network and were identified through diagnosis records, body mass index data, and medication prescribing data. The overall study population was classified into two mutually exclusive cohorts according to pre-diagnosis GLP-1 receptor agonist use: participants with pre-diagnosis GLP-1 receptor agonist use and participants without pre-diagnosis GLP-1 receptor agonist use. Comparator-specific propensity score-matched cohorts for GLP-1 RA versus SGLT2 inhibitors, DPP-4 inhibitors, sulfonylureas, metformin, and usual care were defined within this source population for prespecified pairwise outcome analyses.

Who may be able to join

Adults aged 18 years or older
BMI ≥27 kg/m2, or diagnosis codes consistent with obesity
Type 2 diabetes mellitus
Initiation of a glucose-lowering medication before obesity-associated cancer diagnosis
Incident obesity-associated cancer diagnosed after medication initiation
No dispensing of the study drug class during the 6-month washout period before the first qualifying prescription

Who cannot join

Type 1 diabetes mellitus, Other specified diabetes types that are not type 2 diabetes
Human immunodeficiency virus infection
End-stage renal disease
Prior bariatric surgery
Prior organ transplantation
Transplant-related complications
Any use of tirzepatide before cohort entry

Trial locations and contacts

1 site in 1 country.

Taiwan1 site

Chung Shan Medical University Hospital
Taichung, Taichung City, 402

Other trials in Taiwan

About this study

Official title: Pre-Diagnosis GLP-1 Receptor Agonist Use and Post-Cancer Mortality in Adults With Obesity and Type 2 Diabetes: A Target Trial Emulation

This study will examine whether the type of diabetes treatment used before cancer diagnosis is associated with survival and serious complications after obesity-associated cancer in adults with obesity and type 2 diabetes. The study focuses on glucagon-like peptide-1 receptor agonists (GLP-1 RA) and compares them with other commonly used glucose-lowering therapies, including SGLT2 inhibitors, DPP-4 inhibitors, sulfonylureas, metformin, and usual care. Using de-identified electronic health record data from the TriNetX US Collaborative Network, the study will assess whether patients who used GLP-1 RA before cancer diagnosis have different risks of death, hospitalization, sepsis, and other major outcomes after cancer diagnosis. This is an observational study designed to evaluate associations in routine clinical care and not to prove a treatment effect.

Conditions: Obesity & Overweight, Diabetes Mellitus Type 2, Neoplasms
Medical subject headings: Obesity, Overweight, Diabetes Mellitus, Type 2, Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07513259
Study group	Role	What they receive
GLP-1 RA		Adults with obesity and type 2 diabetes who developed an obesity-associated cancer after initiating a GLP-1 receptor agonist before cancer diagnosis. This cohort served as the GLP-1 RA exposure cohort in the overall study population and represents the unique participants with pre-diagnosis GLP-1 receptor agonist use.
Usual Care Without GLP-1 RA		Adults with obesity and type 2 diabetes who developed an obesity-associated cancer and had no GLP-1 receptor agonist prescriptions before cancer diagnosis. This cohort served as the non-GLP-1 RA comparator cohort in the overall study population. Participants could receive routine clinical care, including other non-GLP-1 RA glucose-lowering medications. This cohort represents the unique participants without pre-diagnosis GLP-1 receptor agonist use.

What is being measured

The primary outcome is the main question the study is designed to answer.

All-cause Mortality (Comparison 1)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
All-cause Mortality (Comparison 2)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
All-cause Mortality (Comparison 3)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
All-cause Mortality (Comparison 4)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
All-cause Mortality (Comparison 5)
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Measured: From obesity-associated cancer diagnosis through 36 months

Secondary outcomes (20)

Inpatient (Comparison 1)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 2)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 3)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 4)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 5)
Inpatient within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Measured: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 1)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 2)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 3)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 4)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 5)
Pericardial effusion within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Measured: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 1)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 2)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 3)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 4)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 5)
Pulmonary embolism within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Measured: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 1)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 2)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 3)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 4)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
Measured: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 5)
Sepsis within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.
Measured: From obesity-associated cancer diagnosis through 36 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

1 Jan 201831 Oct 2025

First posted7 Apr 2026
Study start1 Jan 2018
Primary completion31 Oct 2025
Study completion31 Oct 2025

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
Publications (38)Papers the sponsor has linked to this study.
Other trials for Obesity & OverweightStudies of the same condition, open and under way.
What the trial phases meanHow a treatment moves from first tests in people to approval.

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design

Study type: Observational
Observational model: Cohort
Time perspective: Retrospective
Enrolment: 203,424 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT07513259
Sponsor's protocol ID: CS2-24004
Status last verified: Jun 2026
First submitted: 31 Mar 2026
Last updated: 17 Aug 2026
Results posted: Yes, on ClinicalTrials.gov
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: No: Individual participant data will not be shared. This retrospective observational study uses de-identified electronic health record data from the TriNetX US Collaborative Network. Access to individual-level data is restricted by data use agreements, institutional policies, and privacy protections. Researchers who meet eligibility requirements may obtain access to similar de-identified data through a TriNetX license or through participating institutions.

Publications

Kim C, Dinan MA, Robinson TJ, Ross JS, Jastreboff AM, Krumholz HM, Lu Y. Semaglutide and Tirzepatide Prescribing for Obesity in Patients With Preexisting Comorbid Cancers. JAMA Oncol. 2025 Nov 6;12(1):101-4. doi: 10.1001/jamaoncol.2025.4560. Online ahead of print.
PubMed 41196576
Tsujimoto T, Kajio H, Sugiyama T. Association between hyperinsulinemia and increased risk of cancer death in nonobese and obese people: A population-based observational study. Int J Cancer. 2017 Jul 1;141(1):102-111. doi: 10.1002/ijc.30729. Epub 2017 Apr 22.
PubMed 28390156
Zhang AMY, Wellberg EA, Kopp JL, Johnson JD. Hyperinsulinemia in Obesity, Inflammation, and Cancer. Diabetes Metab J. 2021 May;45(3):285-311. doi: 10.4093/dmj.2020.0250. Epub 2021 Mar 29.
PubMed 33775061
Perkovic V, Tuttle KR, Rossing P, Mahaffey KW, Mann JFE, Bakris G, Baeres FMM, Idorn T, Bosch-Traberg H, Lausvig NL, Pratley R; FLOW Trial Committees and Investigators. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. N Engl J Med. 2024 Jul 11;391(2):109-121. doi: 10.1056/NEJMoa2403347. Epub 2024 May 24.
PubMed 38785209
Wong CK, McLean BA, Baggio LL, Koehler JA, Hammoud R, Rittig N, Yabut JM, Seeley RJ, Brown TJ, Drucker DJ. Central glucagon-like peptide 1 receptor activation inhibits Toll-like receptor agonist-induced inflammation. Cell Metab. 2024 Jan 2;36(1):130-143.e5. doi: 10.1016/j.cmet.2023.11.009. Epub 2023 Dec 18.
PubMed 38113888
Rohm TV, Meier DT, Olefsky JM, Donath MY. Inflammation in obesity, diabetes, and related disorders. Immunity. 2022 Jan 11;55(1):31-55. doi: 10.1016/j.immuni.2021.12.013.
PubMed 35021057
Wong CK, Drucker DJ. Antiinflammatory actions of glucagon-like peptide-1-based therapies beyond metabolic benefits. J Clin Invest. 2025 Nov 3;135(21):e194751. doi: 10.1172/JCI194751. eCollection 2025 Nov 3.
PubMed 41178710
Zheng Z, Zong Y, Ma Y, Tian Y, Pang Y, Zhang C, Gao J. Glucagon-like peptide-1 receptor: mechanisms and advances in therapy. Signal Transduct Target Ther. 2024 Sep 18;9(1):234. doi: 10.1038/s41392-024-01931-z.
PubMed 39289339
Chen B, Yu X, Horvath-Diano C, Ortuno MJ, Tschop MH, Jastreboff AM, Schneeberger M. GLP-1 programs the neurovascular landscape. Cell Metab. 2024 Oct 1;36(10):2173-2189. doi: 10.1016/j.cmet.2024.09.003.
PubMed 39357509
Pfaffenlehner M, Behrens M, Zoller D, Ungethum K, Gunther K, Rucker V, Reese JP, Heuschmann P, Kesselmeier M, Remo F, Scherag A, Binder H, Binder N; EVA4MII project. Methodological challenges using routine clinical care data for real-world evidence: a rapid review utilizing a systematic literature search and focus group discussion. BMC Med Res Methodol. 2025 Jan 14;25(1):8. doi: 10.1186/s12874-024-02440-x.
PubMed 39810151
Zhou L, Duanmu W, Tan F, Gu X, Che H, Yin W. Information pharmacists assist in the construction of GLP-1RA prescription review rules in a tertiary hospital in China. BMC Health Serv Res. 2025 Oct 1;25(1):1276. doi: 10.1186/s12913-025-13377-2.
PubMed 41034888
Arroyo V, Angeli P, Moreau R, Jalan R, Claria J, Trebicka J, Fernandez J, Gustot T, Caraceni P, Bernardi M; investigators from the EASL-CLIF Consortium, Grifols Chair and European Foundation for the Study of Chronic Liver Failure (EF-Clif). The systemic inflammation hypothesis: Towards a new paradigm of acute decompensation and multiorgan failure in cirrhosis. J Hepatol. 2021 Mar;74(3):670-685. doi: 10.1016/j.jhep.2020.11.048. Epub 2020 Dec 7.
PubMed 33301825
Liu C, Liu T, Zhang Q, Song M, Zhang Q, Shi J, Deng L, Chen Y, Zheng X, Lin S, Wang Z, Xie H, Chen S, Wu S, Shi H. Temporal relationship between inflammation and metabolic disorders and their impact on cancer risk. J Glob Health. 2024 Feb 16;14:04041. doi: 10.7189/jogh.14.04041.
PubMed 38386717
Silverii GA, Marinelli C, Bettarini C, Del Vescovo GG, Monami M, Mannucci E. GLP-1 receptor agonists and the risk for cancer: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2025 Aug;27(8):4454-4468. doi: 10.1111/dom.16489. Epub 2025 May 29.
PubMed 40437949
Valencia-Rincon E, Rai R, Chandra V, Wellberg EA. GLP-1 receptor agonists and cancer: current clinical evidence and translational opportunities for preclinical research. J Clin Invest. 2025 Nov 3;135(21):e194743. doi: 10.1172/JCI194743. eCollection 2025 Nov 3.
PubMed 41178720

Want to know more?

The sponsor has not listed a contact. The official record may have more details.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

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Study at a glance

From the registry record, last updated by the sponsor on 17 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Pre-Diagnosis GLP-1 Receptor Agonist Use and Post-Cancer Mortality in Adults With Obesity and Type 2 Diabetes: A Target Trial Emulation
ClinicalTrials.gov ID: NCT07513259
Acronym / sponsor ID: CS2-24004
Conditions: Obesity & Overweight, Diabetes Mellitus Type 2, Neoplasms
Study type: Observational
Recruitment status: Completed
Enrolment: 203,424 participants (actual)
Lead sponsor: Chung Shan Medical UniversityUniversity, hospital or other
Collaborators: National Science and Technology Council, Taiwan
Study start: 1 Jan 2018 (actual)
Primary completion: 31 Oct 2025 (actual)
Study completion: 31 Oct 2025 (actual)
First posted: 7 Apr 2026 (actual)
Results: Posted 17 Aug 2026

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

Study design

Observational model: Cohort
Time perspective: Retrospective
Number of arms: 2

Arm	Type	Receives
GLP-1 RA	–	–Adults with obesity and type 2 diabetes who developed an obesity-associated cancer after initiating a GLP-1 receptor agonist before cancer diagnosis. This cohort served as the GLP-1 RA exposure cohort in the overall study population and represents the unique participants with pre-diagnosis GLP-1 receptor agonist use.
Usual Care Without GLP-1 RA	–	–Adults with obesity and type 2 diabetes who developed an obesity-associated cancer and had no GLP-1 receptor agonist prescriptions before cancer diagnosis. This cohort served as the non-GLP-1 RA comparator cohort in the overall study population. Participants could receive routine clinical care, including other non-GLP-1 RA glucose-lowering medications. This cohort represents the unique participants without pre-diagnosis GLP-1 receptor agonist use.

Who may qualify

Ages: 18 years and older
Sex: All
Healthy volunteers: Not accepted
Age groups: Adult, Older adult
Study population: Adults will be selected from the TriNetX US Collaborative Network, a distributed database of de-identified electronic health records contributed by participating healthcare organizations across multiple clinical systems and practice settings. The study population consists of adults with obesity and type 2 diabetes who received routine clinical care in this network and were identified through diagnosis records, body mass index data, and medication prescribing data. The overall study population was classified into two mutually exclusive cohorts according to pre-diagnosis GLP-1 receptor agonist use: participants with pre-diagnosis GLP-1 receptor agonist use and participants without pre-diagnosis GLP-1 receptor agonist use. Comparator-specific propensity score-matched cohorts for GLP-1 RA versus SGLT2 inhibitors, DPP-4 inhibitors, sulfonylureas, metformin, and usual care were defined within this source population for prespecified pairwise outcome analyses.

Key inclusion criteria (6 listed)

Adults aged 18 years or older
BMI ≥27 kg/m2, or diagnosis codes consistent with obesity
Type 2 diabetes mellitus
Initiation of a glucose-lowering medication before obesity-associated cancer diagnosis
Incident obesity-associated cancer diagnosed after medication initiation

Key exclusion criteria (7 listed)

Type 1 diabetes mellitus, Other specified diabetes types that are not type 2 diabetes
Human immunodeficiency virus infection
End-stage renal disease
Prior bariatric surgery
Prior organ transplantation

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Primary outcome

All-cause Mortality (Comparison 1)
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 1, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior SGLT2 inhibitor use versus SGLT2 inhibitor-treated adults.
All-cause Mortality (Comparison 2)
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 2, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior DPP-4 inhibitor use versus DPP-4 inhibitor-treated adults.
All-cause Mortality (Comparison 3)
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 3, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior sulfonylurea use versus sulfonylurea-treated adults.
All-cause Mortality (Comparison 4)
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 4, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist without prior metformin use versus metformin-treated adults.
All-cause Mortality (Comparison 5)
Time frame: From obesity-associated cancer diagnosis through 36 months
All-cause mortality within 36 months after obesity-associated cancer diagnosis in the propensity score-matched cohort for Comparison 5, comparing adults with obesity and type 2 diabetes treated with GLP-1 receptor agonist versus adults receiving usual care.

20 secondary outcomes

Inpatient (Comparison 1)
Time frame: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 2)
Time frame: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 3)
Time frame: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 4)
Time frame: From obesity-associated cancer diagnosis through 36 months
Inpatient (Comparison 5)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 1)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 2)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 3)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 4)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pericardial Effusion (Comparison 5)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 1)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 2)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 3)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 4)
Time frame: From obesity-associated cancer diagnosis through 36 months
Pulmonary Embolism (Comparison 5)
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 1)
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 2)
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 3)
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 4)
Time frame: From obesity-associated cancer diagnosis through 36 months
Sepsis (Comparison 5)
Time frame: From obesity-associated cancer diagnosis through 36 months

Results and safety

Results posted to the registry on 17 Aug 2026, as reported by the sponsor. Figures are copied from the record, not re-analysed. Full results on ClinicalTrials.gov.

Participant flow

Group	Started	Completed
GLP-1 RA	27,208	27,208
Usual Care Without GLP-1 RA	176,216	176,216

Primary outcome: All-cause Mortality (Comparison 1)

Time frame: From obesity-associated cancer diagnosis through 36 months. Number. Unit: participants with event

Measure	GLP-1 RA Without History of SGLT2i (Comparison 1) n = 12060	SGLT2i (Comparison 1) n = 12125
Value	876	1233

Population analysed: Participants analyzed were members of the corresponding comparison-specific propensity score-matched cohort who were at risk at the start of the 36-month assessment window. Participants with the outcome before the assessment window were excluded. Therefore, the number analyzed may differ across outcomes.

Primary outcome: All-cause Mortality (Comparison 2)

Time frame: From obesity-associated cancer diagnosis through 36 months. Number. Unit: participants with event

Measure	GLP-1 RA Without History of DPP-4i (Comparison 2) n = 10922	DPP-4i (Comparison 2) n = 10984
Value	815	1364

Primary outcome: All-cause Mortality (Comparison 3)

Time frame: From obesity-associated cancer diagnosis through 36 months. Number. Unit: participants with event

Measure	GLP-1 RA Without History of Sulfonylureas (Comparison 3) n = 13801	Sulfonylureas (Comparison 3) n = 13819
Value	883	1736

Primary outcome: All-cause Mortality (Comparison 4)

Time frame: From obesity-associated cancer diagnosis through 36 months. Number. Unit: participants with event

Measure	GLP-1 RA Without History of Metformin (Comparison 4) n = 9590	Metformin (Comparison 4) n = 9645
Value	631	871

20 secondary outcomes are reported in the full results.

Adverse events

Time frame: From index date through 36 months of follow-up. Other adverse events reported at 5% frequency or more

Group	Serious adverse events	Other adverse events	Deaths
GLP-1 RA Without History of SGLT2i (Comparison 1)	0 of 0	0 of 0	876 of 12,060
SGLT2i (Comparison 1)	0 of 0	0 of 0	1,233 of 12,125
GLP-1 RA Without History of DPP-4i (Comparison 2)	0 of 0	0 of 0	815 of 10,922
DPP-4i (Comparison 2)	0 of 0	0 of 0	1,364 of 10,984
GLP-1 RA Without History of Sulfonylureas (Comparison 3)	0 of 0	0 of 0	883 of 13,801
Sulfonylureas (Comparison 3)	0 of 0	0 of 0	1,736 of 13,819
GLP-1 RA Without History of Metformin (Comparison 4)	0 of 0	0 of 0	631 of 9,590
Metformin (Comparison 4)	0 of 0	0 of 0	871 of 9,645
GLP-1 RA (Comparison 5)	0 of 0	0 of 0	1,584 of 25,910
Usual Care (Comparison 5)	0 of 0	0 of 0	2,660 of 25,920

Limitations and caveats (from the sponsor): This retrospective observational target-trial emulation is subject to residual confounding, misclassification, and missing or incomplete electronic health record data. Treatment strategies were not randomly assigned, and propensity score matching was performed separately for each pairwise comparison. Outcome ascertainment may have been affected by variable documentation and follow-up in routine clinical practice.

Loading the posted results from ClinicalTrials.gov…

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 17 Aug 2026.
Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
Background: PubMed 41196576Kim C, Dinan MA, Robinson TJ, Ross JS, Jastreboff AM, Krumholz HM, Lu Y. Semaglutide and Tirzepatide Prescribing for Obesity in Patients With Preexisting Comorbid Cancers. JAMA Oncol. 2025 Nov 6;12(1):101-4. doi: 10.1001/jamaoncol.2025.4560. Online ahead of print.
Background: PubMed 28390156Tsujimoto T, Kajio H, Sugiyama T. Association between hyperinsulinemia and increased risk of cancer death in nonobese and obese people: A population-based observational study. Int J Cancer. 2017 Jul 1;141(1):102-111. doi: 10.1002/ijc.30729. Epub 2017 Apr 22.
Background: PubMed 33775061Zhang AMY, Wellberg EA, Kopp JL, Johnson JD. Hyperinsulinemia in Obesity, Inflammation, and Cancer. Diabetes Metab J. 2021 May;45(3):285-311. doi: 10.4093/dmj.2020.0250. Epub 2021 Mar 29.
Background: PubMed 38785209Perkovic V, Tuttle KR, Rossing P, Mahaffey KW, Mann JFE, Bakris G, Baeres FMM, Idorn T, Bosch-Traberg H, Lausvig NL, Pratley R; FLOW Trial Committees and Investigators. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. N Engl J Med. 2024 Jul 11;391(2):109-121. doi: 10.1056/NEJMoa2403347. Epub 2024 May 24.
Background: PubMed 38113888Wong CK, McLean BA, Baggio LL, Koehler JA, Hammoud R, Rittig N, Yabut JM, Seeley RJ, Brown TJ, Drucker DJ. Central glucagon-like peptide 1 receptor activation inhibits Toll-like receptor agonist-induced inflammation. Cell Metab. 2024 Jan 2;36(1):130-143.e5. doi: 10.1016/j.cmet.2023.11.009. Epub 2023 Dec 18.
Background: PubMed 35021057Rohm TV, Meier DT, Olefsky JM, Donath MY. Inflammation in obesity, diabetes, and related disorders. Immunity. 2022 Jan 11;55(1):31-55. doi: 10.1016/j.immuni.2021.12.013.
Background: PubMed 41178710Wong CK, Drucker DJ. Antiinflammatory actions of glucagon-like peptide-1-based therapies beyond metabolic benefits. J Clin Invest. 2025 Nov 3;135(21):e194751. doi: 10.1172/JCI194751. eCollection 2025 Nov 3.
Background: PubMed 39289339Zheng Z, Zong Y, Ma Y, Tian Y, Pang Y, Zhang C, Gao J. Glucagon-like peptide-1 receptor: mechanisms and advances in therapy. Signal Transduct Target Ther. 2024 Sep 18;9(1):234. doi: 10.1038/s41392-024-01931-z.
Background: PubMed 39357509Chen B, Yu X, Horvath-Diano C, Ortuno MJ, Tschop MH, Jastreboff AM, Schneeberger M. GLP-1 programs the neurovascular landscape. Cell Metab. 2024 Oct 1;36(10):2173-2189. doi: 10.1016/j.cmet.2024.09.003.
Background: PubMed 39810151Pfaffenlehner M, Behrens M, Zoller D, Ungethum K, Gunther K, Rucker V, Reese JP, Heuschmann P, Kesselmeier M, Remo F, Scherag A, Binder H, Binder N; EVA4MII project. Methodological challenges using routine clinical care data for real-world evidence: a rapid review utilizing a systematic literature search and focus group discussion. BMC Med Res Methodol. 2025 Jan 14;25(1):8. doi: 10.1186/s12874-024-02440-x.
Background: PubMed 41034888Zhou L, Duanmu W, Tan F, Gu X, Che H, Yin W. Information pharmacists assist in the construction of GLP-1RA prescription review rules in a tertiary hospital in China. BMC Health Serv Res. 2025 Oct 1;25(1):1276. doi: 10.1186/s12913-025-13377-2.
Background: PubMed 33301825Arroyo V, Angeli P, Moreau R, Jalan R, Claria J, Trebicka J, Fernandez J, Gustot T, Caraceni P, Bernardi M; investigators from the EASL-CLIF Consortium, Grifols Chair and European Foundation for the Study of Chronic Liver Failure (EF-Clif). The systemic inflammation hypothesis: Towards a new paradigm of acute decompensation and multiorgan failure in cirrhosis. J Hepatol. 2021 Mar;74(3):670-685. doi: 10.1016/j.jhep.2020.11.048. Epub 2020 Dec 7.
Individual participant dataSharing planned: No. Individual participant data will not be shared. This retrospective observational study uses de-identified electronic health record data from the TriNetX US Collaborative Network. Access to individual-level data is restricted by data use agreements, institutional policies, and privacy protections. Researchers who meet eligibility requirements may obtain access to similar de-identified data through a TriNetX license or through participating institutions.

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Referral and contact

AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.

The record lists no contact. Use the official record to reach the sponsor.

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

An observational study of Obesity & Overweight and Diabetes Mellitus Type 2, run by Chung Shan Medical University at 1 site in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 17 Aug 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

All-cause Mortality (Comparison 1) (time frame: From obesity-associated cancer diagnosis through 36 months). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07513259, which also lists 38 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Aug 2026.