JAMA network open

GLP-1 Drugs and Serious Eye Problems in People with Type 2 Diabetes

Updated

Abstract

The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was linked to a 7% increased risk of developing diabetic retinopathy (DR).

  • GLP-1 RAs were associated with a hazard ratio of 1.07 for the incidence of DR.
  • No statistically significant increase in the risk of nonarteritic anterior ischemic optic neuropathy (NAION) was found, with a hazard ratio of 1.26.
  • Among patients with preexisting DR, GLP-1 RAs did not lead to significant progression to proliferative DR or diabetic macular edema.
  • Patients using GLP-1 RAs experienced a lower occurrence of vitreous hemorrhages, neovascular glaucoma, and blindness, with hazard ratios of 0.74, 0.78, and 0.77, respectively.
  • Regular screening and monitoring for potential complications of T2D are recommended for all patients treated with GLP-1 RAs, regardless of their DR status.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr D.J. Ramsey reported receiving personal fees from Regeneron Pharmaceuticals and Beaver-Visitec International Inc outside the submitted work. Dr Kosiborod reported receiving institutional support from grants from AstraZeneca, Boehringer Ingelheim, and Pfizer; personal fees from AstraZeneca, Boehringer Ingelheim, Pfizer, 35Pharma, Alnylam, Amgen, Applied Therapeutics, Arrowhead Pharmaceuticals, Bayer, Corcept Therapeutics, Cytokinetics, Dexom, Eli Lilly, Esperion Therapeutics, Imbria Therapeutics, Janssen, Lexicon Pharmaceuticals, Merck, NoroNordisk, Pharmacosmos, Regeneron Pharmaceuticals, Roche, Sanofi, scPharmaceuticals, Structure Therapeutics, Vifor Pharma, and Youngene Therapeutics; stock options held in Artera Health and Saghmos Therapeutics; and salary from AstraZeneca Research and Development outside the submitted work. Dr Fonarow reported receiving personal fees from Abbot, AstraZeneca, Amgen, Bayer, Boehringer Ingelheim, Cytokinetics, Eli Lilly, Johnson & Johnson, Medtronic, Merck, Novartis, and Pfizer outside the submitted work. Dr Nohria reported receiving personal fees from AstraZeneca and Takeda Oncology and grants from Bristol Myers Squibb outside the submitted work. Dr Butler reported receiving personal fees from Abbott, Adaptyx, American Regent, Amgen, AskBio, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cardiac Dimension, Cardior, CSL Vifor, CVRx, Cytokinetics, Daxor, Diastol, Edwards, Element Sciences, Faraday, Idorsia, Impulse Dynamics, Imbria, Innolife, Intellia, Inventiva, Levator, Lexicon, Eli Lilly, Mankind, Medtronic, Merck, New Amsterdam, Novartis, NovoNordisk, Pfizer, Pharmacosmos, Pharmain, Prolaio, Pulnovo, Regeneron Pharmaceuticals, Renibus, Reprieve, Roche, Rycarma, Saillent, Salamandra, Salubris, scPharmaceuticals, SQ Innovation, Secretome, Sequanna, Transmural, TekkunLev, Tenex, Tricog, Ultromic, Vera, and Zoll outside the submitted work. No other disclosures were reported.
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