TOPLINE:
Clients treated with glucagon-like peptide 1 receptor agonists (GLP-1 RAs) appear to have a really low occurrence of nonarteritic anterior ischemic optic neuropathy (NAION) when properly recommended for weight problems or diabetes.
APPROACH:
- A retrospective observational research study just recently recommended that semaglutide treatment might be connected with more than a fourfold boost in the threat for NAION, an uncommon condition possibly causing loss of sight that is more regular in individuals with weight problems and diabetes.
- To examine the danger for NAION in adult clients getting GLP-1 RAs for diabetes or weight problems, scientists performed this meta-analysis, that included 69 randomized regulated trials that lasted a minimum of 12 months, compared GLP-1s to a placebo or an active comparator (control arm), and revealed a total list of severe negative occasions.
- The analysis consisted of 144,226 and 132,922 patient-years in the GLP-1 RA and control arms, respectively, and the trials utilized liraglutide (23 trials), semaglutide (19 trials), exenatide (15 trials), dulaglutide (7 trials), and lixisenatide (one trial).
- The majority of trials (n = 52) registered clients with type 2 diabetes just, while 17 registered those with weight problems; the mean age and body mass index of these clients were 57 years and 32, respectively, with the average research study period being 56 weeks.
- The endpoint was the distinction in the occurrence of NAION, as reported by detectives as a severe negative occasion.
TAKEAWAY:
- Of the 69 trials, just 5 reported cases of NAION– 8 cases in the GLP-1 group and 4 in the control group; the staying 64 trials did not report any case of NAION.
- Amongst the various GLP-1s, 6 cases were kept in mind in those utilizing semaglutide and one case each in those utilizing liraglutide and dulaglutide.
- GLP-1 treatment was not connected with an increased danger for NAION (chances ratio, 1.53; 95% CI, 0.53-4.44; P =.43).
- The approximated outright boost in the danger for NAION with GLP-1 treatment was 2.6 per 100,000 patient-years (however it was kept in mind that a boost of 570 per 100,000 patient-years would have been required to attain 80% analytical power).
IN PRACTICE:
“An appropriate boost of the relative danger for an extremely unusual, although serious, condition does not customize the total risk-benefit ratio of reliable drugs, a minimum of when properly recommended,” the authors composed. “At the exact same time, we need to know that the unsuitable usage of drugs for causing weight-loss in reasonably obese clients with low cardiovascular threat might be connected with uncommon however serious negative results, perhaps consisting of NAION,” they included.
SOURCE:
The research study was led by Giovanni Antonio Silverii, MD, Experimental and Clinical Biomedical Sciences ‘Mario Serio’ Department, University of Florence, Florence, Italy. It was released online in Diabetes, Obesity and Metabolism
RESTRICTIONS:
With such an unusual condition, the scientific trial numbers are not yet enough to show an association or develop the security of GLP-1s, specifically for semaglutide,