Semaglutide Use in Diabetes Doubles Risk of Irreversible Vision Loss, claims study
Researchers have established that the application of once-weekly semaglutide in patients with type 2 diabetes (T2D) increases the risk of nonarteritic anterior ischemic optic neuropathy (NAION). A recent study was conducted by Jakob G. and colleagues which was published in the International Journal of Retina and Vitreous.
The primary aim of this study was to prospectively evaluate the risk of NAION in people with T2D exposed to semaglutide compared with those who were not, by employing a strong longitudinal cohort design.
This was a five-year longitudinal cohort study (2018–2024) which identified all individuals with T2D in Denmark (n = 424,152). The cohort was stratified into two groups:
• Semaglutide exposure group: 106,454 people who were dispensed once-weekly semaglutide.
• Non-exposure group: 317,698 people who did not receive semaglutide.
The incidence rates and HRs of NAION were evaluated using a multivariable Cox proportional hazards regression model. Observations included a total of 1,915,120 person-years.
Results
Baseline Characteristics:
• Median age: 65 years.
• Median hemoglobin A1c: 50 mmol/mol.
• Men: 54.5%.
NAION Incidence:
• Total NAION cases: 218.
• Exposure group: Semaglutide exposure, 67 cases (median time from first prescription to NAION, 22.2 months; interquartile range, 10.2–37.8 months).
• Non-exposure group: 151 cases.
Incidence Rates:
• Semaglutide exposure: 0.228 per 1000 person-years.
• Non-exposure: 0.093 per 1000 person-years (p < 0.001).
Risk Assessment:
• After adjusting for multiple confounding factors, the use of semaglutide independently predicted a 2.19-fold higher risk of NAION (HR 2.19; 95% CI, 1.54–3.12).
This nationwide study found that semaglutide use in T2D patients more than doubled the risk of NAION. Given the severe and irreversible nature of this condition, these findings emphasize the importance of recognizing this risk in clinical practice and tailoring treatment plans accordingly.
Reference:
Grauslund, J., Taha, A. A., Molander, L. D., Kawasaki, R., Möller, S., Højlund, K., & Stokholm, L. (2024). Once-weekly semaglutide doubles the five-year risk of nonarteritic anterior ischemic optic neuropathy in a Danish cohort of 424,152 persons with type 2 diabetes. International Journal of Retina and Vitreous, 10(1). https://doi.org/10.1186/s40942-024-00620-x
