Study links stopping GLP-1 therapy in type 2 diabetes to higher cardiovascular risk
An observational study of over 80,000 Italian patients found that discontinuing GLP-1 drugs was associated with roughly double the risk of heart attack, stroke or death, especially among those with obesity.
An observational study of more than 80,000 Italians with type 2 diabetes and no prior heart disease found that patients who stopped GLP-1 weight-loss medications faced about twice the annual risk of non-fatal heart attack, stroke or death compared with those who remained on the drugs. The analysis, published in Lancet Regional Health Europe, reported four events per 100 person-years among discontinuers versus two per 100 among continuers.
The increased risk was most pronounced in participants with a body-mass index of 30 or higher, a threshold used to define medical obesity. About 60% of the cohort discontinued therapy after roughly one year, while those who stayed on treatment did so for an average of three years.
Researchers cautioned that, as an observational study, it cannot establish a causal link between stopping the medication and the adverse outcomes. The British Medical Journal noted that the higher event rate might reflect poorer underlying health among those who stopped, and that the study did not explore reasons for discontinuation, such as gastrointestinal side effects or cost.
Cardiologist and epidemiologist Dr. Christopher Labos of McGill University said the findings underscore the cardiovascular benefit of GLP-1 drugs and warned against stopping them without medical justification. "If you’re stopping them just because you think they’ve worked and now you want to stop, number one, you are probably going to see a regain of the weight," he said, adding that patients would lose the metabolic and cardiovascular protection provided by the therapy.
The study primarily involved users of liraglutide and dulaglutide, with only a small number of semaglutide patients; newer agents such as tirzepatide were not included because they entered the market after the study period. Researchers emphasized that the results should not be taken to imply the drugs are dangerous, but rather that they are chronic treatments that should not be started and stopped arbitrarily.
Further research is needed to determine whether discontinuation directly causes the heightened risk or merely signals higher underlying vulnerability.