GLP-1 Receptor Agonists and Venous Thromboembolism Risk in Multiple Myeloma

 

BACKGROUND 

• Multiple myeloma (MM) carries a substantially elevated risk of venous thromboembolism (VTE), driven by disease biology and by therapy related factors.

• GLP-1 receptor agonists (GLP-1 RAs) may influence thrombotic risk through platelet inhibition and endothelial modulation.

• Thromboprophylaxis in MM is guided by risk scores with modest discrimination, so identifying modifiable exposures that shift thrombotic risk is clinically relevant.

• The association of GLP-1 RA exposure with VTE in MM has not previously been evaluated.

 

METHODS

• Design: retrospective cohort, TriNetX US Collaborative Network.

• Population: adults ≥18 years with MM.

• Exposure: semaglutide, liraglutide, dulaglutide, exenatide or tirzepatide within 3 months before or after MM diagnosis.

• Excluded: baseline anticoagulation; prior VTE.

• Matching: sex, race, diabetes, obesity, atrial fibrillation, hypertensive disease, use of: thalidomide, lenalidomide, pomalidomide, dexamethasone - 860 pairs.

• Analysis: Risk ratio, Cox hazard ratio, Kaplan-Meier VTE-free survival.

 

Comparison: MM patients with GLP-1 RA exposure versus 1:1 propensity-matched MM patients without exposure.

Primary outcome: incident VTE (pulmonary embolism or other venous thrombosis), assessed from day 90 after the index date.

 

CONCLUSION

• GLP-1 RA use was associated with a lower cumulative incidence of VTE (4.9% vs 9.2%; RR 0.53).

• The time-to-event analysis showed a numerically lower hazard that did not reach statistical significance (HR 0.79, 95% CI 0.53-1.16).

• These findings support prospective evaluation of GLP-1 RAs and thrombotic risk in MM.