Higher generally known as the antidiabetic-slash-weight loss medication Ozempic and Wegovy, semaglutide has grow to be one thing of a ‘surprise drug,’ with analysis commonly discovering its further medical advantages. Nonetheless, a brand new examine has discovered that the drug doubtlessly has a critical draw back.
New analysis led by the Massachusetts Eye and Ear Hospital (Mass Eye and Ear) discovered that semaglutide use was related to nonarteritic anterior ischemic optic neuropathy (NAION), or ‘eye stroke,’ a situation that may trigger sudden imaginative and prescient loss.
“Using these medication has exploded all through industrialized nations they usually have offered very important advantages in some ways, however future discussions between a affected person and their doctor ought to embrace NAION as a possible danger,” mentioned Joseph Rizzo, MD, director of the Neuro-Ophthalmology Service at Mass Eye and Ear and the Simmons Lessell Professor of Ophthalmology at Harvard Medical Faculty, and the examine’s senior creator.
NAION is a comparatively uncommon situation attributable to impaired blood circulation to the optic nerve (what ‘ischemic’ refers to within the situation’s title), which transmits data from the attention to the mind. It’s known as ‘nonarteritic’ as a result of the lowered blood movement isn’t related to true blood vessel irritation (as seen in arteritis). ‘Anterior’ refers back to the front-most a part of the optic nerve, the place it meets the attention, whereas ‘optic neuropathy’ is as a result of it causes damage to the optic nerve, resulting in sudden, painless imaginative and prescient loss. In extreme instances, NAION could cause blindness. There isn’t any present therapy for the situation.
The precise mechanism that causes NAION isn’t identified. What is thought is that the situation is seen extra usually in sufferers with diabetes, hypertension, and sleep apnea. After noticing an increase in sufferers taking semaglutide presenting with imaginative and prescient loss attributable to NAION, the researchers undertook a retrospective examine to analyze whether or not there was a hyperlink between the 2.
Semaglutide mimics a naturally produced hormone known as glucagon-like peptide 1 (GLP-1). It connects with GLP-1 receptors within the physique, reducing blood sugar ranges and making folks really feel fuller and fewer hungry.
The researchers examined knowledge from 16,827 Mass Eye and Ear sufferers seen by neuro-ophthalmologists – medical docs who focus on treating imaginative and prescient points linked to neurological circumstances – between December 2017 and November 2023. The common age was 47, and 52% have been feminine. The sufferers have been divided into these with kind 2 diabetes and people who have been chubby or overweight. These teams have been then additional divided into these prescribed semaglutide or a non-GLP-1 medicine to deal with their respective circumstances. Not one of the individuals had a historical past of NAION.
Propensity matching – a statistical matching approach that makes an attempt to estimate the impact of a therapy by accounting for covariates that predict receiving the therapy – was used to evaluate whether or not prescribed semaglutide was related to NAION. Components reminiscent of intercourse, age, hypertension, kind 2 diabetes, weight problems, obstructive sleep apnea, excessive blood lipids and coronary artery illness have been accounted for.
Amongst 710 individuals with kind 2 diabetes, 194 have been prescribed semaglutide, and 516 have been prescribed a non-GLP-1 antidiabetic medicine. The researchers discovered that 17 NAION occasions occurred in sufferers prescribed semaglutide versus six within the sufferers taking non-GLP-1 meds. The cumulative incidence of NAION over three years was 8.9% for the semaglutide-prescribed group in comparison with 1.8% for the non-GLP-1-prescribed group. These findings counsel that kind 2 diabetics prescribed semaglutide have been 4 occasions extra prone to be recognized with NAION.
Of the 979 chubby or overweight individuals, 361 have been prescribed semaglutide, and 618 have been prescribed a non-GLP-1 weight reduction medicine. For these sufferers, 20 NAION occasions occurred within the sufferers prescribed semaglutide and three occurred within the non-GLP-1-prescribed cohort. The cumulative incidence of NAION over three years was 6.7% within the semaglutide group and 0.8% within the non-GLP-1 group, that means they have been seven occasions extra prone to develop the situation.
There are limitations to the examine. All individuals attended Mass Eye and Ear, which sees a excessive variety of folks with uncommon eye ailments. They have been principally white, and the variety of NAION instances seen over the examine interval was comparatively small. Moreover, the researchers couldn’t decide whether or not individuals really had their prescriptions disbursed or had began taking semaglutide after which stopped.
Additional, as that is an observational examine, the researchers couldn’t say that semaglutide induced an elevated danger of growing NAION, simply that the information counsel an affiliation between the 2. Additional analysis is required to evaluate causality.
“Our findings ought to be seen as being important however tentative, as future research are wanted to look at these questions in a a lot bigger and extra various inhabitants,” Rizzo mentioned. “That is data we didn’t have earlier than, and it ought to be included in discussions between sufferers and their docs, particularly if sufferers produce other identified optic nerve issues like glaucoma or if there’s preexisting important visible loss from different causes.”
The examine was printed within the journal JAMA Ophthalmology.
Supply: Mass Eye and Ear