Journal of the American Heart AssociationMay 2, 2025

Glucagon-Like Peptide-1 Receptor Agonists and the Risk of Blood Clots in Veins: A Review and Analysis of Clinical Trials

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jan 20, 2026

Abstract

A total of 39 randomized controlled trials involving 70,499 participants were included in the analysis of glucagon-like peptide 1 receptor agonists and venous thromboembolism risk.

A nonsignificant upward trend in the risk of venous thromboembolism was observed among participants using GLP-1 receptor agonists (odds ratio 1.19).
GLP-1 receptor agonists were significantly associated with an increased risk of deep vein thrombosis (odds ratio 1.64).
The risk difference indicated 25 more events per 10,000 person-years for deep vein thrombosis among users of GLP-1 receptor agonists.
Increased risk of deep vein thrombosis was particularly noted in trials with treatment duration greater than 1.5 years (odds ratio 2.32).
A significant association with deep vein thrombosis was also found in cardiovascular outcome trials (odds ratio 2.18).
No significant association was observed between GLP-1 receptor agonists and the risk of pulmonary embolism.

Simplified

BACKGROUND: Limited data exist on the association of glucagon-like peptide 1 receptor agonists (GLP-1RAs) with the risk of venous thromboembolism. This meta-analysis aimed to investigate the association between GLP-1RAs and the risk of venous thromboembolism including deep vein thrombosis (DVT) and pulmonary embolism.

METHODS AND RESULTS: A systematic search of PubMed, Web of Science, EMBASE, and Cochrane library was conducted from inception until July 3, 2024, to identify randomized controlled trials comparing GLP-1RAs with placebo or other anti-iabetic drugs, with reported data on DVT and pulmonary embolism. The primary outcome was venous thromboembolism, and secondary outcomes included DVT and pulmonary embolism. Pooled odds ratios (ORs) were calculated using fixed-effects models with Mantel-Haenszel method and treatment arm continuity correction for zero-event trials. A total of 39 randomized controlled trials involving 70 499 participants were included. A nonsignificant upward trend in the risk of venous thromboembolism was observed among participants using GLP-1RAs (OR, 1.19 [95% CI, 0.94-1.50]). GLP-1RAs were significantly associated with an increased risk of DVT (OR, 1.64 [95% CI, 1.14-2.36]); risk difference 25 (5-52) more events per 10 000 person-years). Subgroup analyses revealed that increased risk of DVT was particularly prominent in randomized controlled trials with treatment duration >1.5 years (OR, 2.32 [95% CI, 1.49-3.60]) and in cardiovascular outcome trials (OR, 2.18 [95% CI, 1.36-3.49]). No significant association was observed between GLP-1RAs and risk of pulmonary embolism.

CONCLUSIONS: GLP-1RAs might increase the risk of DVT, especially for long-term use of GLP-1RAs. Clinicians should be aware of this potential risk when prescribing GLP-1RAs.

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Competing interests

All authors have completed the International Committee of Medical Journal Editors uniform disclosure form and declare: no support from any organization for the submitted work; no financial relationship with any organization that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

PubMed

Glucagon-Like Peptide-1 Receptor Agonists and the Risk of Blood Clots in Veins: A Review and Analysis of Clinical Trials

Abstract

Full Text

Funding

Competing interests

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