Wiley
CME: Semaglutide is associated with an increased risk of optic neuropathy
November 21, 2024
CME CREDITS - 0.50
POEMS (Patient-Oriented Evidence that Matters)
Clinical question:
Does semaglutide use increase the risk of vision loss secondary to nonarteritic anterior ischemic optic neuropathy (NAION)?
Bottom line:
This study found a significant association between semaglutide use and NAION in adults with type 2 diabetes or who are overweight/obese. It is difficult to generalize findings from this highly selective referral population, but the strong association of increased risk with semaglutide is concerning. Thus, further evidence regarding the absolute risk of NAION for the millions of patients who are using semaglutide is needed. (LOE = 2b)
Synopsis:
NAION is a rare cause of blindness with an annual incidence of 2 to 155 cases per 100,000 persons, with higher risk occurring in elderly patients with diabetes. These investigators retrospectively analyzed data from patients (n = 1,689), 12 years or older, with either type 2 diabetes or overweight/obesity, who were referred to a tertiary-care based neuro-ophthalmology clinic for visual problems. To assess whether there is an association between semaglutide use and the risk of NAION, matching occurred to account for potential confounding variables, including sex, age, hypertension, sleep apnea, hyperlipidemia, and coronary artery disease, as well as contraindications for the use of semaglutide (eg, chronic kidney disease, pancreatitis, or other medications associated with NAION).
In patients with type 2 diabetes, NAION occurred significantly more often in patients who were prescribed semaglutide vs patients who were prescribed other standard diabetic medications (8.9% vs. 1.8%; hazard ratio [HR] = 4.28; 95% CI 1.62 - 11.29). Similarly, NAION occurred significantly more often in overweight/obese patients who were prescribed semaglutide vs other weight-loss medications (6.7% vs. 0.8%; HR = 7.64; 2.21 - 26.36).
David C. Slawson, MD
Reference:
Hathaway JT, Shah MP, Hathaway DB, et al. Risk of nonarteritic anterior ischemic optic neuropathy in patients prescribed semaglutide. JAMA Ophthalmol 2024;142(8):732-739. https://pubmed.ncbi.nlm.nih.gov/38958939/
Copyright © 2024 John Wiley & Sons, Inc.
The above message comes from Wiley Essential Evidence Plus, who is solely responsible for its content.
TRENDING THIS WEEK