Diabetes Drugs Linked To Higher Risk Of Rare Optic Nerve Damage

New investigation links 2 wide utilized glucosuria drugs, semaglutide aliases tirzepatide, to a uncommon but perchance vision-threatening oculus condition, raising questions astir drug-specific risks and nan request for person monitoring.

Study: Semaglutide aliases Tirzepatide and Optic Nerve and Visual Pathway Disorders successful Type 2 Diabetes. Image credit: Vince Scherer/Shutterstock.com

A study published successful JAMA Network Open reported that curen pinch antidiabetic medicines semaglutide and tirzepatide increases nan consequence of optic neuropathy and different optic nervus disorders successful patients pinch type 2 diabetes.  

Background

Glucagon-like peptide-1 receptor agonists (GLP-1RA) are a group of medications wide utilized to dainty diabetic aliases obese individuals. These medications person precocious imaginable to trim diabetes-related complications, including cardiovascular and nephrological disorders.

Semaglutide and tirzepatide are second-generation GLP-1RA medications approved by nan U.S. Food and Drug Administration (FDA) for treating glucosuria and obesity. However, these medications are associated pinch adverse broadside effects, including gastrointestinal disorders, thyroid C-cell tumors, and pancreatitis.

Some caller studies person linked semaglutide and tirzepatide pinch accrued consequence of nonarteritic anterior ischemic optic neuropathy. However, nan reported associations are inconclusive, and it mostly remains chartless whether these medications are associated pinch an accrued consequence of different optic nervus disorders.

In nan existent study, researchers investigated nan associations betwixt curen pinch either semaglutide aliases tirzepatide and nan consequence of optic nervus and ocular pathway disorders successful patients pinch type 2 diabetes.

Nonarteritic anterior ischemic optic neuropathy is characterized by nonaccomplishment of imagination owed to impaired humor travel to nan optic nerve. The information is much prevalent among patients pinch diabetes, obesity, hypertension, hyperlipidemia, cerebrovascular disease, and obstructive slumber apnea.

Study design

The study utilized a nationwide, multicenter database of physics wellness records of much than 118 cardinal US patients to comparison semaglutide aliases tirzepatide pinch different antidiabetic medications for nan associated consequence of optic nervus and ocular pathway disorders successful patients pinch type 2 diabetes.

The target organization successful nan database was type 2 glucosuria patients pinch nary anterior test of oculus disorder, who were consuming semaglutide, tirzepatide, aliases different GLP-1RA and non-GLP-1RA antidiabetic medications.

Key findings

The study of physics wellness records revealed that astir 0.04% of patients who were treated pinch either semaglutide aliases tirzepatide had developed nonarteritic anterior ischemic optic neuropathy complete 2 years, arsenic compared to 0.02% of patients who were treated pinch different antidiabetic medications.

The prevalence of different optic nervus disorders was 0.12% among semaglutide- aliases tirzepatide-treated patients, compared to 0.07% among patients receiving non-GLP-1RA antidiabetic medications.

Compared to different GLP-1RAs, semaglutide aliases tirzepatide was associated pinch a importantly accrued consequence of different optic nervus disorders; nan accrued consequence of NAION was directionally higher but did not scope statistical significance.

Study significance

The study finds that compared to different antidiabetic medications, curen pinch either semaglutide aliases tirzepatide is associated pinch an accrued consequence of nonarteritic anterior ischemic optic neuropathy and different optic nervus disorders. However, nan wide consequence is low.

The study could not find immoderate relation betwixt curen pinch semaglutide aliases tirzepatide and consequence of optic neuritis, papilledema, aliases optic atrophy, compared pinch each different antidiabetic medications. However, successful a head-to-head versus different GLP-1RAs, location was a important relation pinch different optic disc disorders. This deficiency of relation mightiness beryllium owed to nan chopped pathophysiology of each optic nervus and ocular pathway disorder.

Notably, nan study reports that curen pinch either semaglutide aliases tirzepatide is consistently associated pinch an accrued consequence of processing optic nervus disorders. Another notable uncovering is that compared to different GLP-1RAs, semaglutide aliases tirzepatide is associated pinch accrued risks of optic neuropathy and different optic nervus disorders. These patterns suggest, though do not prove, that nan observed associations whitethorn beryllium circumstantial to these 2 medications alternatively than nan GLP-1RA people arsenic a whole.

A nonstop power of GLP-1RAs tin beryllium expected arsenic GLP-1 receptors are expressed successful nan optic nerve. However, these findings propose that nan observed associations mightiness besides impact indirect links pinch abrupt changes successful metabolic parameters. Further studies are needed to replicate these findings, research underlying mechanisms, and place individuals pinch higher susceptibility to these imaginable complications.

Due to nan observational study design, nan study could not find nan causality of observed associations. Moreover, nan study observations are based connected patients’ physics wellness reports, which person their limitations of unmeasured aliases uncontrolled confounding and biases.

The study progressive patients pinch type 2 glucosuria who were followed up for 2 years. The study utilized International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code H47.01, “ischemic optic neuropathy” for nonarteritic anterior ischemic optic neuropathy diagnosis, arsenic nary circumstantial ICD-10 code is disposable for this disease. ICD-10–based diagnoses whitethorn person immoderate limitations owed to overdiagnosis, misdiagnosis, and underdiagnosis. Furthermore, owed to information inaccessibility, nan researchers could not manually reappraisal patient-level information to corroborate illness diagnosis.  

The researchers analyzed wide and circumstantial ICD-10 illness codes to systematically place nan associations of semaglutide aliases tirzepatide pinch optic nervus and ocular pathways. They observed that these 2 medications are preferably associated pinch optic nerves but not different ocular pathways. These findings supply a instauration for early investigation to attraction connected circumstantial oculus disorders.

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