Data and Temporal Risk Concerns of Semaglutide and NAION—Reply - Takeaways - MDSpire
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Reply: Data Interpretation and Temporal Risk of Semaglutide-Associated NAION

  • By

  • Kent R. Heberer

  • Adam P. Bress

  • Jennifer S. Lee

  • October 1, 2026

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  • 1

    At day 182.5, the SGLT2i risk-table count, cumulative NAION events, and cumulative censoring total reconciled to the full cohort of 90,883 patients.

  • 2

    Censoring included deaths, prespecified competing events, and end of follow-up; the authors found no indication that it was informative regarding treatment.

  • 3

    In the overlap-weighted cohort, cause-specific treatment HRs were 1.78 (95% CI, 0.90-3.51) during year 1 and 2.93 (95% CI, 1.75-4.91) thereafter, with no significant between-period difference (P = .25

  • 4

    Scaled Schoenfeld residuals showed no detected temporal trend (χ²₁ = 0.084; P = .77), supporting the reported HR as an effect summary averaged across follow-up.

  • 5

    The NAION coding algorithm had an approximately 74.5% positive predictive value, and the authors found no evidence of treatment-group differences in misclassification.

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