Ozempic Linked to Elevated Danger of Blinding Eye Situation

Ozempic Linked to Elevated Danger of Blinding Eye Situation
Ozempic Linked to Elevated Danger of Blinding Eye Situation


Abstract: A brand new examine reveals that sufferers prescribed semaglutide (Ozempic or Wegovy) for diabetes or weight reduction have the next threat of growing NAION, a doubtlessly blinding eye situation.

Diabetic sufferers on semaglutide had been over 4 instances extra prone to be identified with NAION, whereas chubby sufferers had been over seven instances extra probably. The findings counsel the necessity for cautious discussions between sufferers and medical doctors about this threat. NAION stays a uncommon however severe situation with no efficient remedies.

Key Information:

  1. Semaglutide customers with diabetes are over 4 instances extra prone to develop NAION.
  2. Chubby sufferers on semaglutide have a sevenfold elevated threat of NAION.
  3. NAION is a uncommon situation with no present efficient remedies.

Supply: Mass Normal

A brand new examine led by investigators from Mass Eye and Ear discovered that sufferers prescribed semaglutide (as Ozempic or Wegovy) for diabetes or weight reduction had the next threat of getting a doubtlessly blinding eye situation known as NAION than related sufferers who had not been prescribed these medication.

Notably, the examine discovered folks with diabetes who had been prescribed semaglutide by their doctor after which crammed the prescription had been greater than 4 instances extra prone to be identified with NAION. Those that had been chubby or had weight problems and prescribed this drug had been greater than seven instances extra prone to get the analysis.

Importantly, the examine doesn’t show causality, and the researchers don’t know why or how this affiliation exists, and why there was a distinction reported in diabetic and chubby teams. Credit score: Neuroscience Information

The examine, which was led by Joseph Rizzo, MD, director of the Neuro-Ophthalmology Service at Mass Eye and Ear and the Simmons Lessell Professor of Ophthalmology at Harvard Medical Faculty,  printed July 3rd in JAMA Ophthalmology.

“The usage of these medication has exploded all through industrialized international locations they usually have offered very important advantages in some ways, however future discussions between a affected person and their doctor ought to embrace NAION as a possible threat,” stated Rizzo, the examine’s corresponding writer.

“It is very important respect, nevertheless, that the elevated threat pertains to a dysfunction that’s comparatively unusual.” 

NAION is comparatively uncommon, occurring as much as 10 out of 100,000 folks within the normal inhabitants. NAION is the second-leading reason behind optic nerve blindness (second solely to glaucoma) and it’s the most typical reason behind sudden optic nerve blindness. NAION is considered brought on by lowered blood circulation to the optic nerve head, with the consequence of everlasting visible loss in a single eye.

In accordance with Rizzo, the visible loss brought on by NAION is painless and should progresses over many days earlier than stabilizing, and there may be comparatively little potential for enchancment. There are presently no efficient remedies for NAION. 

The impetus for the examine occurred within the late summer time of 2023 when Rizzo, a resident (examine co-author Seyedeh Maryam Zekavat, MD, PhD) and different Mass Eye and Ear neuro-ophthalmologists observed a disturbing pattern — three sufferers of their follow had been identified with imaginative and prescient loss from this comparatively unusual optic nerve illness in only one week. The physicians noticed all three had been taking semaglutide.

This anecdotal recognition led the Mass Eye and Ear analysis staff to run a backward-looking evaluation of their affected person inhabitants to see if they might determine a hyperlink between this illness and these medication, which had been surging in reputation.

Semaglutide was developed to deal with kind 2 diabetes. The drug encourages weight reduction, and its use has snowballed since its launch as Ozempic for diabetes in 2017. The drug was additionally authorised for weight administration, branded as Wegovy, and launched in 2021.

The researchers analyzed the information of greater than 17,000 Mass Eye and Ear sufferers handled over the six years since Ozempic was launched and divided the sufferers in those that had been identified with both diabetes or chubby/ weight problems.

The researchers in contrast sufferers who had obtained prescriptions for semaglutide in comparison with these taking different diabetes or weight reduction medication. Then, they analyzed the speed of NAION diagnoses within the teams, which revealed the numerous threat will increase.

There are a number of limitations to the examine. Mass Eye and Ear sees an unusually excessive variety of folks with uncommon eye illnesses, the examine inhabitants is majority white, and the variety of NAION instances seen over the six-year examine interval is comparatively small. With small case numbers, statistics can change shortly, Rizzo famous.

The researchers additionally couldn’t decide if the sufferers really took their treatment or in the event that they began after which stopped taking semaglutide in some unspecified time in the future and the way this may need impacted their threat.  

Importantly, the examine doesn’t show causality, and the researchers don’t know why or how this affiliation exists, and why there was a distinction reported in diabetic and chubby teams.

“Our findings ought to be seen as being important however tentative, as future research are wanted to look at these questions in a a lot bigger and extra various inhabitants,” Rizzo stated.

“That is data we didn’t have earlier than and it ought to be included in discussions between sufferers and their medical doctors, particularly if sufferers produce other recognized optic nerve issues like glaucoma or if there may be preexisting important visible loss from different causes.”

Authorship: Along with Rizzo and Zekavat, different Mass Normal Brigham co-authors embrace Jimena Tatiana Hathaway, MD, MPH (MEE); Madhura P. Shah, BS (MEE); David B. Hathaway, MD (BWH); Drenushe Krasniqi, BA (MEE); John W. Gittinger Jr, MD (MEE); Dean Cestari, MD (MEE); Robert Mallery, MD (MEE); Bardia Abbasi, MD (MEE); Marc Bouffard, MD (MEE); Bart Ok. Chwalisz, MD (MEE) and Tais Estrela, MD (MEE).

Disclosures: No conflicts of curiosity reported.

Funding: This work was funded partly by a grant from Analysis to Stop Blindness.

About this imaginative and prescient and neuropharmacology analysis information

Creator: Tim Sullivan
Supply: Mass General
Contact: Tim Sullivan – Mass Normal
Picture: The picture is credited to Neuroscience Information

Authentic Analysis: Closed entry.
Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide” by Joseph Rizzo et al. JAMA Opthalmology


Summary

Danger of Nonarteritic Anterior Ischemic Optic Neuropathy in Sufferers Prescribed Semaglutide

Significance  

Anecdotal expertise raised the chance that semaglutide, a glucagon-like peptide 1 receptor agonist (GLP-1 RA) with quickly rising use, is related to nonarteritic anterior ischemic optic neuropathy (NAION).

Goal  

To analyze whether or not there may be an affiliation between semaglutide and threat of NAION.

Design, Setting, and Members  

In a retrospective matched cohort examine utilizing knowledge from a centralized knowledge registry of sufferers evaluated by neuro-ophthalmologists at 1 educational establishment from December 1, 2017, by way of November 30, 2023, a seek for Worldwide Statistical Classification of Illnesses and Associated Well being Issues, Tenth Revision code H47.01 (ischemic optic neuropathy) and textual content search yielded 16 827 sufferers with no historical past of NAION.

Propensity matching was used to evaluate whether or not prescribed semaglutide was related to NAION in sufferers with kind 2 diabetes (T2D) or chubby/weight problems, in every case accounting for covarying components (intercourse, age, systemic hypertension, T2D, obstructive sleep apnea, weight problems, hyperlipidemia, and coronary artery illness) and contraindications to be used of semaglutide.

The cumulative incidence of NAION was decided with the Kaplan-Meier technique and a Cox proportional hazards regression mannequin adjusted for potential confounding comorbidities. Knowledge had been analyzed from December 1, 2017, by way of November 30, 2023.

Exposures  

Prescriptions for semaglutide vs non–GLP-1 RA drugs to handle both T2D or weight.

Primary Outcomes and Measures  

Cumulative incidence and hazard ratio of NAION.

Outcomes  

Amongst 16 827 sufferers, 710 had T2D (194 prescribed semaglutide; 516 prescribed non–GLP-1 RA antidiabetic drugs; median [IQR] age, 59 [49-68] years; 369 [52%] feminine) and 979 had been chubby or overweight (361 prescribed semaglutide; 618 prescribed non–GLP-1 RA weight-loss drugs; median [IQR] age, 47 [32-59] years; 708 [72%] feminine). Within the inhabitants with T2D, 17 NAION occasions occurred in sufferers prescribed semaglutide vs 6 within the non–GLP-1 RA antidiabetes cohort.

The cumulative incidence of NAION for the semaglutide and non–GLP-1 RA cohorts over 36 months was 8.9% (95% CI, 4.5%-13.1%) and 1.8% (95% CI, 0%-3.5%), respectively. A Cox proportional hazards regression mannequin confirmed greater threat of NAION for sufferers receiving semaglutide (hazard ratio [HR], 4.28; 95% CI, 1.62-11.29); P < .001). Within the inhabitants of sufferers who had been chubby or overweight, 20 NAION occasions occurred within the prescribed semaglutide cohort vs 3 within the non–GLP-1 RA cohort.

The cumulative incidence of NAION for the semaglutide vs non–GLP-1 RA cohorts over 36 months was 6.7% (95% CI, 3.6%-9.7%) and 0.8% (95% CI, 0%-1.8%), respectively. A Cox proportional hazards regression mannequin confirmed the next threat of NAION for sufferers prescribed semaglutide (HR, 7.64; 95% CI, 2.21-26.36; P < .001).

Conclusions and Relevance  

This examine’s findings counsel an affiliation between semaglutide and NAION. As this was an observational examine, future examine is required to evaluate causality.

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