JAMA ophthalmology

Semaglutide and Sudden Vision Loss from Non-Inflammatory Optic Nerve Damage

Updated

Abstract

The incidence rate of nonarteritic anterior ischemic optic neuropathy (NAION) among new semaglutide users was 14.5 per 100,000 person-years.

  • A total of 37.1 million individuals with type 2 diabetes were included in the analysis, with 810,390 being new users of semaglutide.
  • Among new semaglutide users, 56% were aged 50 to 69 years and 61% were female.
  • The hazard ratio for NAION among new users of semaglutide compared to non-GLP-1RAs was not statistically different using a sensitive definition.
  • Using a specific definition of NAION, semaglutide users had a higher risk compared to those taking empagliflozin.
  • Self-controlled case-series analysis indicated a modestly increased risk of NAION associated with semaglutide use.

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Funding

Competing interests

Conflict of Interest Disclosures: Dr Cai reported receiving grants from Regeneron Pharmaceuticals outside the submitted work. Dr Baxter reported receiving grants from National Institutes of Health (NIH) and Research to Prevent Blindess, personal fees from Topcon, and nonfinancial support from Optomed outside the submitted work. Dr Swaminathan reported receiving personal fees from AbbVie, Elios Vision, and Lumata Health and grants from Heidelberg Engineering outside the submitted work. Dr Toy reported receiving advisory board fees from Alimera Sciences, Bausch & Lomb, and Regeneron outside the submitted work. Dr C. Lee reported receiving grants from NIH, Centers for Disease Control and Prevention, and the Alzheimer’s Disease Drug Foundation outside the submitted work. Dr Leng reported receiving grants from Astellas and personal fees from Topcon, Astellas, Alcon, Boehringer Ingelheim, Iridex, Nanoscope, Regeneron, Genentech/Roche, Virtual Field, Aptitude Medical, Protagonist Therapeutics, Apellis, and Graybug outside the submitted work. Dr Boland reported receiving personal fees from Carl Zeiss Meditec, Topcon Healthcare, Allergan, and Janssen during the conduct of the study. Dr Swerdel reported being an employee and shareholder of Johnson & Johnson outside the submitted work. Dr Suchard reported receiving grants from NIH, US Department of Veterans Affairs, and the US Food and Drug Administration and personal fees from Johnson & Johnson outside the submitted work. Drs Schuemie and Sena reported being and employee and shareholder of Johnson & Johnson outside the submitted work. Dr DuVall reported receiving grants from Alnylam Pharmaceuticals, Astellas Pharma, AstraZeneca, Biodesix, Celgene Corp, Cerner Enviza, GSK, IQVIA, Janssen Pharmaceuticals, Moderna, Novartis International AG, and Parexel International Corp outside the submitted work. Dr Lai reported being a shareholder of Johnson & Johnson outside the submitted work. Dr Brash reported being employed by IQVIA outside the submitted work. Dr Mawn reported receiving grants from Research to Prevent Blindness and consultant fees from Amgen and Genentech. Dr Ryan reported being an employee and shareholder of Johnson & Johnson. No other disclosures were reported.
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