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GLP-1s are being linked to fewer serious infections, including TB

gizmodo.com

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Re: GLP-1s are being linked to fewer serious infections, including TB

#11

Post by clickety_clack »

acheron wrote: post #10
master_crab wrote: post #2

Using a large database of (deidentified) medical records, the researchers compared the outcomes of people taking a GLP-1 for their type 2 diabetes to people taking other common diabetes drugs between 2017 and 2025. GLP-1 users were significantly less likely to be diagnosed with TB for up to a five-year span, they found. Both of these studies are observational and retrospective, meaning they can only show a correlatio…

Wow, bet they never thought of that. If only the researchers had thought to ask HN first.

Would you prefer that people accept claims uncritically? It’s a valid critique of the results.

Re: GLP-1s are being linked to fewer serious infections, including TB

#12

Post by wvenable »

clickety_clack wrote: post #11
acheron wrote: post #10

Earlier quoted context omitted.

Wow, bet they never thought of that. If only the researchers had thought to ask HN first.

Would you prefer that people accept claims uncritically? It’s a valid critique of the results.

If the commenter read the study and found that they did not, in fact, account for that then it would be valid to point it out here.

Otherwise, it's just a waste of our time.

Re: GLP-1s are being linked to fewer serious infections, including TB

#15

Post by tptacek »

joaopbnogueira wrote: post #3
master_crab wrote: post #2

Using a large database of (deidentified) medical records, the researchers compared the outcomes of people taking a GLP-1 for their type 2 diabetes to people taking other common diabetes drugs between 2017 and 2025. GLP-1 users were significantly less likely to be diagnosed with TB for up to a five-year span, they found. Both of these studies are observational and retrospective, meaning they can only show a correlatio…

Or having a lower % of body fat (within healthy limits) is the factor improving a better immune response?

Generally studies showing off-target effects with GLP1s are at least attempting to control for this.

Re: GLP-1s are being linked to fewer serious infections, including TB

#16

Post by tptacek »

drusepth wrote: post #13
tarxvf wrote: post #4

How expensive are GLP-1s again?

> GLP-1 receptor agonist medications typically cost between $149 and $350 per month for cash-pay oral pills, and $900 to $1,400+ per month for list-price injectables without insurance.

I don't know that anyone really pays list price for injectables, because the vendors do discount programs. Without insurance coverage, tirzepetide via Amazon Pharmacy is something like $450/mo.

Re: GLP-1s are being linked to fewer serious infections, including TB

#17

Post by k12sosse »

drusepth wrote: post #13
tarxvf wrote: post #4

How expensive are GLP-1s again?

> GLP-1 receptor agonist medications typically cost between $149 and $350 per month for cash-pay oral pills, and $900 to $1,400+ per month for list-price injectables without insurance.

Canada has generic semiglutide for under/around $300/mo depending on pharmacy

Re: GLP-1s are being linked to fewer serious infections, including TB

#18

Post by nxobject »

ramraj07 wrote: post #8
master_crab wrote: post #2

Using a large database of (deidentified) medical records, the researchers compared the outcomes of people taking a GLP-1 for their type 2 diabetes to people taking other common diabetes drugs between 2017 and 2025. GLP-1 users were significantly less likely to be diagnosed with TB for up to a five-year span, they found. Both of these studies are observational and retrospective, meaning they can only show a correlatio…

They use a method called propensity score matching to try their best to match patients on both sides using a simple linear model with various features that try to ensure that only pairs of closely matched patient histories are compared. Unfortunately this is rarely clean. Its also easy to make mistakes. Sometimes two arms are fundamentally incomparable. The quality and rigor of the comparison is often determined by a…

It looks like both do standard individual covariate checks for post-match balance, with SMDs. I'm surprised they haven't assessed balance for at least pairwise interactions, too -- we should be balancing out joint risk factors too, no?

I haven't worked on these designs, but I remember the methodologist that taught me this in grad school giving us a lecture about this.

EDIT: the BMJ article (laudably) provides access to the analyis code, although I won't have time to review it:

github.com/nilskruger/Tirzepatide-and-the-Risk-of-Atherosclerotic-Cardiovascular-Events

Re: GLP-1s are being linked to fewer serious infections, including TB

#19

Post by mathgeek »

tptacek wrote: post #15
joaopbnogueira wrote: post #3

Earlier quoted context omitted.

Or having a lower % of body fat (within healthy limits) is the factor improving a better immune response?

Generally studies showing off-target effects with GLP1s are at least attempting to control for this.

I’d be interested to see the data for that claim, since I would imagine a strong correlation between glp use and lower body fat.

Re: GLP-1s are being linked to fewer serious infections, including TB

#20

Post by jakevoytko »

tptacek wrote: post #16
drusepth wrote: post #13

Earlier quoted context omitted.

> GLP-1 receptor agonist medications typically cost between $149 and $350 per month for cash-pay oral pills, and $900 to $1,400+ per month for list-price injectables without insurance.

I don't know that anyone really pays list price for injectables, because the vendors do discount programs. Without insurance coverage, tirzepetide via Amazon Pharmacy is something like $450/mo.

Yeah this is what I pay for Zepbound through LillyDirect. I also eat less food and drink less alcohol than I used to. So the net loss is probably smaller, maybe $200/mo
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