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CC BY 4.0 · Semin Thromb Hemost 2025; 51(07): 756-767
DOI: 10.1055/a-2546-0353
Review Article

Novel Antidiabetic Drugs and Risk of Venous Thromboembolism: A Literature Review

Authors

  • Qingui Chen 

    1   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

  • Rayna J.S. Anijs

    1   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
    2   Department of Medicine, Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
    3   The Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands

  • Judith P.L. Verlaan

    1   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

  • Luuk J.J. Scheres 

    1   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
    4   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

  • Frederikus A. Klok

    2   Department of Medicine, Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands

  • Suzanne C. Cannegieter

    1   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
    2   Department of Medicine, Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
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Abstract

Novel antidiabetic drugs, particularly sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, have significantly transformed the management landscape for type 2 diabetes mellitus, cardiovascular diseases, and chronic kidney diseases, owing to their well-established cardiorenal protective effects. Given the shared risk factors and comorbidities, it is relevant to consider the potential risk of venous thromboembolism (VTE) in individuals prescribed these novel antidiabetic medications. This literature review aims to summarize currently available evidence on VTE risk associated with novel antidiabetic drugs, including GLP-1 receptor agonists, dipeptidyl-peptidase IV (DPP-4) inhibitors, and SGLT2 inhibitors. Following a comprehensive search on PubMed using relevant keywords and backward reference searching, we identified 25 publications that directly reported on associations between these medications and VTE risk. Findings from these studies, including seven meta-analyses, reveal inconsistent results: some studies suggest that GLP-1 receptor agonists or DPP-4 inhibitors may be associated with increased risk of VTE, whereas SGLT2 inhibitors do not appear to be associated with VTE and may even be a protective factor. A notable limitation of the existing studies is the significant challenge posed by confounding in observational studies, while the randomized controlled trials (RCTs) often concluded with a limited number of VTE events, if it was studied. Furthermore, all identified studies focused on the risk of primary VTE, leaving an important knowledge gap regarding whether these novel antidiabetic drugs may influence the efficacy or safety of anticoagulants used for preventing VTE recurrence. Addressing these gaps presents an important avenue for future research.

Keywords

glucagon-like peptide-1 receptor agonists - dipeptidyl-peptidase IV inhibitors - sodium-glucose transporter 2 inhibitors - venous thromboembolism - hypoglycemic agents

Declaration of GenAI Use

GPT-4o with canvas by OpenAI was subsequently used to enhance language and clarity, with all suggested changes reviewed through Microsoft Word's Track Changes feature. Each modification was manually assessed for appropriateness, with additional revisions made by the authors as necessary. Plagiarism checks were conducted on both the initial and edited drafts using iThenticate. Upon reasonable request, the draft and track changes documentation can be provided by the corresponding author.


Authors' Contributions

Q.C. conducted the literature search and independently wrote the initial draft of the manuscript before it underwent language editing. All other authors contributed to the critical revision of the manuscript for important intellectual content.


Supplementary Material



Publication History

Received: 09 February 2025

Accepted: 24 February 2025

Article published online:
28 March 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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