Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of injective anti-diabetic drugs that improve
glycemic control and many other
atherosclerosis-related parameters in patients with
type 2 diabetes (T2D). However, the use of this relatively new class of drugs may be associated with certain adverse effects. Concerns have been expressed regarding the effects of these drugs on pancreatic and thyroid tissue, since animal studies and analyses of drug databases indicate an association of
GLP-1 receptor agonists with
pancreatitis,
pancreatic cancer, and
thyroid cancer. However, several meta-analyses failed to confirm a cause-effect relation between
GLP-1 receptor agonists and the development of these adverse effects. One benefit of
GLP-1 receptor agonists is that they do not cause
hypoglycemia when combined with
metformin or
thiazolidinediones, but the dose of concomitant sulphonylurea or
insulin may have to be decreased to reduce the risk of
hypoglycemic episodes. On the other hand, several case reports have linked the use of these drugs, mainly
exenatide, with the occurrence of
acute kidney injury, primarily through hemodynamic derangement due to
nausea,
vomiting, and
diarrhea. The most common symptoms associated with the use of
GLP-1 receptor agonists are gastrointestinal symptoms, mainly
nausea. Other common adverse effects include
injection site reactions,
headache, and
nasopharyngitis, but these effects do not usually result in discontinuation of the drug. Current evidence shows that
GLP-1 receptor agonists have no negative effects on the cardiovascular risk of patients with T2D. Thus,
GLP-1 receptor agonists appear to have a favorable safety profile, but ongoing trials will further assess their cardiovascular effects. The aim of this review is to analyze critically the available data regarding adverse events of
GLP-1 receptor agonists in different anatomic systems published in Pubmed and Scopus. Whenever possible, certain differences between
GLP-1 receptor agonists are described. The review also provides the reader with structured data that compare the rates of the most common adverse effects for each of the various
GLP-1 receptor agonists.