Glucagon-like peptide 1 receptor agonists and risk of venous thromboembolism: a systematic review and meta-analysis of randomized controlled trials

Department

Internal Medicine

Document Type

Article

Publication Title

Journal of Thrombosis and Haemostasis

Abstract

BACKGROUND: Obesity is an established risk factor for venous thromboembolism (VTE). Observational data suggest that glucagon-like peptide 1 receptor agonists (GLP-1RAs) may reduce the risk of VTE. However, the effects of GLP-1RAs on VTE have not been tested in randomized controlled trials (RCTs).

OBJECTIVES: To investigate the impact of GLP-1RAs on VTE risk using data from RCTs.

METHODS: We conducted a systematic review and meta-analysis of placebo-controlled RCTs focusing on GLP-1RA use in patients with type 2 diabetes mellitus (T2DM) or obesity. Five databases were searched from inception to October 2024. The primary outcome was VTE, which was a composite of pulmonary embolism (PE), deep vein thrombosis, and VTE at other sites, and the secondary outcomes were the individual events.

RESULTS: Twenty-seven RCTs with 84 003 patients were analyzed. The median incidence of VTE was 1.1 and 2.5 per 1000 patient-years in the GLP-1RA and placebo groups, respectively. There was no statistically significant difference in overall VTE risk between GLP-1RA and placebo groups (risk ratio [RR], 0.70; 95% CI, 0.46-1.07). However, GLP-1RAs were associated with a significantly lower risk of PE (RR, 0.60; 95% CI, 0.39-0.94). In contrast, there were no significant differences in the risk of deep vein thrombosis (RR, 1.21; 95% CI, 0.69-2.12) or VTE at other sites (RR, 0.56; 95% CI, 0.25-1.26).

CONCLUSION: In this meta-analysis of randomized trials, GLP-1RAs were not associated with a significant reduction in overall VTE risk but were associated with a lower risk of PE among patients with T2DM or obesity.

First Page

3527

Last Page

3539

DOI

10.1016/j.jtha.2025.06.020

Volume

23

Issue

11

Publication Date

11-1-2025

Publisher

Blackwell Pub.

Medical Subject Headings

Humans; Venous Thromboembolism; Randomized Controlled Trials as Topic; Glucagon-Like Peptide-1 Receptor Agonists; Diabetes Mellitus, Type 2; Obesity; Risk Factors; Risk Assessment; Pulmonary Embolism; Incidence; Venous Thrombosis; Treatment Outcome; Incretins; Hypoglycemic Agents; Female; Male; Middle Aged

PubMed ID

40602613

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