To evaluate the association between GLP-1 receptor agonists, particularly semaglutide, and the risk of ischaemic optic neuropathy (ION) using FDA adverse event reports.
Key Findings:
Semaglutide was the only GLP-1RA associated with a significant signal for ION.
Wegovy showed the strongest association with ION, nearly five times higher risk compared to Ozempic.
No ION cases were reported with oral semaglutide (Rybelsus).
Men receiving Wegovy had particularly high reporting odds for ION, while Ozempic cases were more common in women.
No signal for ION was detected with tirzepatide or comparator drugs like metformin and insulin.
Interpretation:
The findings suggest a potential safety signal for ION associated with high-dose semaglutide, particularly Wegovy, warranting further investigation.
Limitations:
No direct clinical link established between semaglutide and ION.
Observational nature of the analysis limits causal inference.
Conclusion:
Further prospective studies are needed to clarify the relationship between semaglutide and NAION risk, especially regarding specific formulations and patient demographics.
US claims data showed rising prevalence of diabetic retinal disease in type 1 and type 2 diabetes, while incidence declined in type 1 diabetes and moved closer to type 2 rates by 2022.
