Work

Glucagon‐like peptide 1 ( GLP1 ) receptor agonists and risk for ischemic optic neuropathy: A meta‐analysis of randomised controlled trials

Year: 2024

Type: article

Study designs: Systematic Review, Meta-Analysis

Abstract: BACKGROUNDGlucagon-like peptide-1 receptor agonists (GLP-1 RA) are an established treatment for type 2 diabetes; due to their weight-reducing effect, some of the molecules of the class are increasingly used as a treatment for obesity. 1 The use of GLP-1 RA is associated with a reduction of major cardiovascular events, 2 with possible improvements of heart failure, 3,4 and renal function.5 An increased risk for worsening pre-existing diabetic retinopathy was also observed in a large trial with semaglutide, 6 but it may be the consequence of a sudden and wide reduction of hyperglycaemia.7 Recently, a retrospective observational study highlighted the possibility of an association of semaglutide treatment with a more than four-fold increase in risk for nonarteritic anterior ischemic optic neuropathy (NAION), but the results could be affected by selection bias, as the study was performed in a sample referring to a specialist facility.8 NAION, a condition potentially leading to blindness, is relatively rare in the general population (2-10/100 000 cases/year), 9,10 but more frequent in patients with obesity, diabetes and possibly obstructive sleep apnoea.10,11 Because GLP-1 receptors have been detected in neuronal cells in the human eye, 12 a possible effect of GLP1-RA on optic neuropathy is not implausible.However, a retrospective study, even when well-designed, cannot provide any demonstration of causal relationships, because the possibility of confounding factors cannot be entirely ruled out.In case of suggestions of safety issues detected in observational studies, the retrieval of specific data from randomised trial can therefore add relevant information.

Source: Diabetes Obesity and Metabolism

DOI: 10.1111/dom.16076

Authors: Giovanni Antonio Silverii, Laura Pala, Barbara Cresci, Edoardo Mannucci

Institutions: University of Florence, Azienda Ospedaliero-Universitaria Careggi

Language: English

Topic: Diabetes Treatment and Management

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $5,190