Glucagon-Like Peptide-1 Receptor Agonists are Not Associated with an Increased Risk of Progressing to Vision-Threatening Diabetic Retinopathy.

IF 1.7 4区 医学 Q3 OPHTHALMOLOGY Ophthalmic epidemiology Pub Date : 2024-10-10 DOI:10.1080/09286586.2024.2399764
Zujaja Tauqeer, Peter Bracha, Peiying Hua, Yinxi Yu, Qi N Cui, Brian L VanderBeek
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Abstract

Purpose: Glucagon-like peptide-1 receptor agonists (GLP-1RA) are used to treat type 2 diabetes mellitus (DM) by augmenting insulin release and sensitivity. We assessed the overall risk for development of vision-threatening diabetic retinopathy (VTDR), proliferative diabetic retinopathy (PDR), and diabetic macular edema (DME), among GLP-1RA users.

Methods: A retrospective cohort of patients with NPDR newly started on a GLP-1RA from a national insurance claims database was compared to a cohort of patients treated with other oral anti-diabetic agents and matched for age, sex, race, index year, and number of active diabetic medications. Exclusions occurred for < 2 years in the database before diagnosis; prior diagnoses of PDR, DME, vitreous hemorrhage, and/or other retinal vascular diseases; and prior intraocular treatment for VTDR.

Results: A total of 6093 users of GLP-1RA were matched to 14,122 controls. In the GLP-1RA cohort, 632 (10.1%), 76 (1.2%), and 544 (8.9%) patients progressed to VTDR, PDR, or DME, respectively. This is compared to 1332 (9.5%) VTDR, 165 (1.2%) PDR, or 1148 (8.1%) DME in the control group. Accounting for underlying DM severity with IPTW, no difference in hazard was seen in the GLP-1RA cohort compared to controls for progression to VTDR (HR = 1.02, 95%CI: 0.92-1.14 p = 0.69), DME (HR = 1.06, 95%CI: 0.95-1.1.9, p = 0.31), or PDR (HR = 0.81, 95%CI: 0.58-1.12, p = 0.20).

Conclusion: We found no difference in the risk for vision-threatening diabetic retinopathy, nor for its component diseases, DME or PDR, with GLP-1RA use compared to other oral anti-hyperglycemic agents in patients with NPDR.

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胰高血糖素样肽-1 受体激动剂与恶化为危及视力的糖尿病视网膜病变的风险增加无关。
目的:胰高血糖素样肽-1受体激动剂(GLP-1RA)通过增强胰岛素的释放和敏感性来治疗2型糖尿病(DM)。我们评估了GLP-1RA使用者发生危及视力的糖尿病视网膜病变(VTDR)、增殖性糖尿病视网膜病变(PDR)和糖尿病黄斑水肿(DME)的总体风险:方法:将全国保险理赔数据库中新开始使用 GLP-1RA 的 NPDR 患者回顾性队列与使用其他口服抗糖尿病药物治疗的患者队列进行比较,并在年龄、性别、种族、指数年份和有效糖尿病药物数量方面进行匹配。排除结果:共有 6093 名 GLP-1RA 使用者与 14122 名对照者进行了匹配。在 GLP-1RA 组群中,分别有 632 例(10.1%)、76 例(1.2%)和 544 例(8.9%)患者发展为 VTDR、PDR 或 DME。相比之下,对照组中有 1332 例(9.5%)VTDR、165 例(1.2%)PDR 或 1148 例(8.1%)DME。考虑到IPTW的潜在DM严重程度,GLP-1RA组与对照组相比,在进展为VTDR(HR = 1.02,95%CI:0.92-1.14,p = 0.69)、DME(HR = 1.06,95%CI:0.95-1.1.9,p = 0.31)或PDR(HR = 0.81,95%CI:0.58-1.12,p = 0.20)的风险方面没有差异:我们发现,与其他口服降糖药物相比,NPDR 患者使用 GLP-1RA 后,发生危及视力的糖尿病视网膜病变的风险,以及发生 DME 或 PDR 的风险均无差别。
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来源期刊
Ophthalmic epidemiology
Ophthalmic epidemiology 医学-眼科学
CiteScore
3.70
自引率
5.60%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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