Glucagon-like peptide-1 receptor agonists and risk of sight-threatening retinopathy in Taiwanese population: A propensity based cohort study

Aug 11, 2024Diabetes & metabolic syndrome

Glucagon-like peptide-1 drugs and risk of serious eye disease in Taiwanese people

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Abstract

In a study involving 27,506 matched pairs, GLP-1 receptor agonist use was not linked to a higher risk of vision-threatening retinopathy compared to non-use.

GLP-1 receptor agonist use did not show an increased risk of vision-threatening retinopathy compared to non-use (adjusted hazard ratio 0.96).
Users of GLP-1 receptor agonists had a significantly lower risk of vision-threatening retinopathy compared to those using dipeptidyl peptidase-4 inhibitors (adjusted hazard ratio 0.8).
There was no significant difference in the risk of vision-threatening retinopathy between GLP-1 receptor agonist users and those using sodium-glucose cotransporter-2 inhibitors (adjusted hazard ratio 1.09).
GLP-1 receptor agonist use also did not show a significant difference in risk compared to sulfonylurea users (adjusted hazard ratio 0.79).

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AIMS: To compare the risk of vision-threatening retinopathy between glucagon-like peptide-1 receptor agonists (GLP-1 RA) use and no use in patients with type 2 diabetes.

METHODS: Using propensity score matching, we identified 27,506 pairs of GLP-1 RA users and non-users, 3904 pairs of GLP-1 RA and dipeptidyl peptidase-4 inhibitors (DPP-4i) users, 10,985 pairs of GLP-1 RA and sodium-glucose cotransporter-2 inhibitors (SGLT2i) users, 2542 pairs of GLP-1 RA and sulfonylurea, respectively, from Taiwan's National Health Insurance Research Database from January 1, 2009 to December 31, 2018. We used Cox proportional hazards models to compare the risk of vision-threatening retinopathy between GLP-1 RA use and other matched groups.

RESULTS: In the matched cohorts, the time-varying exposure analysis showed that GLP-1 RA use was not associated with an increased risk of vision-threatening retinopathy compared to GLP-1 RA non-use (aHR 0.96, 95 % CI 0.89-1.03). New-user and active-comparator analyses showed that GLP-1 RA was associated with a significantly lower risk of vision-threatening retinopathy than DPP-4i (aHR 0.8, 95 % CI 0.66-0.97) but had no significant association with this risk compared to SGLT2i (aHR 1.09, 95 % CI 0.96-1.24) or sulfonylureas (aHR 0.79, 95 % CI 0.49-1.06).

CONCLUSIONS: This nationwide cohort study showed that GLP-1 RA use was not associated with an increased risk of vision-threatening retinopathy compared to non- GLP-1 RA use, and GLP-1 RA could significantly lower the risk of vision-threatening retinopathy than DPP-4i.

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Glucagon-like peptide-1 receptor agonists and risk of sight-threatening retinopathy in Taiwanese population: A propensity based cohort study

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