Quick answer
A hereditary syndrome causing tumors of the thyroid, adrenal, and parathyroid glands. Personal or family history of MEN2 is an absolute contraindication to GLP-1 RA therapy.
Full definition
Multiple Endocrine Neoplasia type 2 (MEN2) is an autosomal dominant disorder caused by mutations in the RET proto-oncogene. It predisposes to medullary thyroid carcinoma (nearly 100% lifetime risk), pheochromocytoma, and (in MEN2A) parathyroid adenoma. Because all GLP-1 RAs carry a boxed warning about thyroid C-cell tumors observed in rodents, personal or family history of MEN2 (or medullary thyroid carcinoma) is a labeled contraindication for all currently marketed GLP-1 receptor agonists.
Deep dive
MEN2 (Multiple Endocrine Neoplasia Type 2): complete reference
Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) is a rare inherited cancer-predisposition syndrome caused by mutations in the RET proto-oncogene. Three subtypes: MEN 2A (medullary thyroid carcinoma + pheochromocytoma + parathyroid hyperplasia), MEN 2B (MTC + pheochromocytoma + mucosal neuromas + marfanoid features), and Familial Medullary Thyroid Carcinoma (FMTC, MTC alone). MEN 2 affects roughly 1 in 30,000-40,000 individuals. Critical для GLP-1 prescribing: MEN 2 is an absolute contraindication to all GLP-1 receptor agonists due to theoretical risk of accelerating thyroid C-cell tumor development (based on rodent studies). Screening for MEN 2: personal or family history of MTC, RET genetic testing for at-risk individuals, calcitonin baseline measurement. The boxed warning on GLP-1 labels specifically lists MEN 2 as contraindication. All prescribers screen для personal/family thyroid cancer history at GLP-1 initiation; positive history triggers further evaluation before proceeding или alternative therapy selection.
- In practice
- Before prescribing Wegovy, your doctor asks "any family history of thyroid cancer or MEN 2?" — those questions screen for the boxed warning contraindication.
- Clinical context
- MEN 2 is absolute contraindication to all GLP-1s. Family history screening is standard before initiation.
Medications
MEN2 (Multiple Endocrine Neoplasia Type 2) is most directly relevant to the following GLP-1 medications:
Related terms
- Boxed Warning — The strongest FDA warning, displayed in a literal box on the drug label. All GLP-1 RAs carry a boxed…
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GLP1Zoom glossary is educational reference. Definitions are summary interpretations of clinical sources and not a substitute for prescribing-information detail. Full disclaimer.
References
Glucagon-Like Peptide-1 Receptor Agonists: Mechanisms и Clinical Use (Drucker, Cell Metabolism)(2018)
Tirzepatide GIP/GLP-1 Dual Agonism: Mechanism Review (Lancet Diabetes & Endocrinology)(2021)
GLP-1 Effects on Gastric Emptying: Pharmacology Review (American J Physiology)(2020)
Endocrine Society Clinical Practice Guideline: Pharmacological Management of Obesity(2015)
STEP-1 trial: Once-Weekly Semaglutide in Adults with Overweight or Obesity (Wilding et al., NEJM)(2021)
SURMOUNT-1 trial: Tirzepatide Once Weekly для Treatment of Obesity (Jastreboff et al., NEJM)(2022)
SUSTAIN-6 trial: Semaglutide and Cardiovascular Outcomes (Marso et al., NEJM)(2016)
SURPASS-2 trial: Tirzepatide vs Semaglutide в Type 2 Diabetes (Frias et al., NEJM)(2021)
LEADER trial: Liraglutide and Cardiovascular Outcomes в T2D (Marso et al., NEJM)(2016)