Association between Semaglutide and Non-Arteritic Anterior Ischemic Optic Neuropathy: A Multinational Population-Based Real-World Study.

IF 13.1 1区医学 Q1 OPHTHALMOLOGY Ophthalmology Pub Date : 2024-11-02 DOI:10.1016/j.ophtha.2024.10.030

Chien-Chih Chou, Ssu-Yu Pan, Yi-Jing Sheen, Jun-Fu Lin, Chien-Heng Lin, Hui-Ju Lin, I-Jong Wang, Chien-Hsiang Weng

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Abstract

Objective: To investigate whether semaglutide increases the risk of non-arteritic anterior ischemic optic neuropathy (NAION) in the general population.

Design: This retrospective cohort study utilized a de-identified global electronic medical records database. The enrollment period was extended from January 2017 to August 2023, with observations concluding in August 2024.

Participants: This study included individuals with type 2 diabetes mellitus (T2DM) or obesity. They were further categorized into T2DM-only, obesity-only, and T2DM with obesity groups to assess the differences among these subgroups. The effects of semaglutide were compared with those of glucose-lowering or weight loss medications other than glucagon-like peptide receptor agonists.

Methods: Patient data were obtained from 160 healthcare organizations across 21 countries. Outcomes were evaluated at one, two, and three years of follow-up. A 1:1 propensity score matching was performed to balance age, sex, body mass index, hemoglobin A1C, medications, and underlying comorbidities. Cox regression models were used to compute hazard ratios (HR) and 95% confidence intervals (CI).

Main outcome measures: The occurrence of NAION.

Results: The final analysis included 37,245 participants with T2DM-only, 33,537 participants with obesity-only, and 64,989 participants with both T2DM and obesity. The results indicated that the administration of semaglutide was not associated with the development of NAION in the T2DM-only group (1 year follow-up: HR, 2.32; 95% CI, 0.60-8.97; 2 years: HR, 2.31; 95% CI, 0.86-6.17; 3 years: HR, 1.51; 95% CI, 0.71-3.25), the obesity-only group (1 year follow-up: HR, 0.25; 95% CI, 0.03-2.28; 2 years: HR, 0.44; 95% CI, 0.09-2.21; 3 years: HR, 0.44; 95% CI, 0.09-2.21), and the T2DM with obesity group (1 year follow-up: HR, 0.81; 95% CI, 0.42-1.57; 2 years: HR, 1.2; 95% CI, 0.74-1.94; 3 years: HR, 1.19; 95% CI, 0.78-1.82).

Conclusions: The findings suggest that semaglutide may not be associated with an increased risk of NAION in the general population. Therefore, avoidance of semaglutide based solely on concerns regarding the risk of NAION may not be warranted, as its potential benefits for blood glucose control and cardiovascular health likely outweigh its potential risks.

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塞马鲁肽与非动脉炎性前部缺血性视神经病变的关系：一项基于多国人群的真实世界研究。

目的调查在普通人群中，塞马鲁肽是否会增加非动脉炎性前部缺血性视神经病变（NAION）的风险：这项回顾性队列研究利用了一个去标识化的全球电子病历数据库。入组时间从2017年1月延长至2023年8月，观察于2024年8月结束：研究对象包括 2 型糖尿病（T2DM）患者或肥胖症患者。他们被进一步分为纯 T2DM 组、纯肥胖组和 T2DM 伴肥胖组，以评估这些亚组之间的差异。将赛马鲁肽的疗效与胰高血糖素样肽受体激动剂以外的降糖或减肥药物的疗效进行比较：方法：从 21 个国家的 160 家医疗机构获取患者数据。对随访一年、两年和三年的结果进行了评估。在平衡年龄、性别、体重指数、血红蛋白 A1C、药物和基础合并症的基础上进行了 1:1 倾向评分匹配。采用考克斯回归模型计算危险比（HR）和 95% 置信区间（CI）：结果：最终分析包括 37,245 名仅患有 T2DM 的参与者、33,537 名仅患有肥胖症的参与者以及 64,989 名同时患有 T2DM 和肥胖症的参与者。结果表明，在仅患有 T2DM 的组别中，服用塞马鲁肽与 NAION 的发生无关（随访 1 年：HR，2.32；95% CI，0.60-8.97；随访 2 年：HR，2.31；95% CI，0.60-8.97）：HR，2.31；95% CI，0.86-6.17；3 年：HR，1.51；95% CI，0.71-3.25）、单纯肥胖组（1 年随访：HR，0.25；95% CI，0.03-2.28；2 年随访：HR，0.44；95% CI，0.60-8.97；2 年随访：HR，2.31；95% CI，0.86-6.17；3 年随访：HR，1.51；95% CI，0.71-3.25）：HR，0.44；95% CI，0.09-2.21；3 年：HR，0.44；95% CI，0.09-2.21），以及 T2DM 伴肥胖组（随访 1 年：HR，0.81；95% CI，0.42-1.57；2 年：HR，1.2；95% CI，0.03-2.28）：HR，1.2；95% CI，0.74-1.94；3 年：结论：结论：研究结果表明，在普通人群中，塞马鲁肽可能与NAION风险增加无关。因此，仅仅因为担心NAION的风险而避免服用塞马鲁肽可能是没有必要的，因为它对血糖控制和心血管健康的潜在益处可能超过其潜在风险。

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来源期刊

Ophthalmology 医学-眼科学

CiteScore

22.30

自引率

3.60%

发文量

412

审稿时长

18 days

期刊介绍： The journal Ophthalmology, from the American Academy of Ophthalmology, contributes to society by publishing research in clinical and basic science related to vision.It upholds excellence through unbiased peer-review, fostering innovation, promoting discovery, and encouraging lifelong learning.

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