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Study: Vision Impairment Signals Linked to Semaglutide Use
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Key Takeaways
- Semaglutide is associated with increased reports of vision impairment compared to other GLP-1 receptor agonists and antidiabetic drugs.
- The study found higher reporting odds ratios for semaglutide-related vision issues compared to DPP-4 inhibitors, SGLT2 inhibitors, and metformin.
The findings suggest a potentially elevated risk of vision impairment with semaglutide (Ozempic, Wegovy; Novo Nordisk) use compared to other weight loss and diabetes medications.
As the use of semaglutide (Ozempic, Wegovy; Novo Nordisk) has increased in managing type 2 diabetes (T2D) and obesity, researchers have raised concerns about a potential link with ocular impairments. To help address these concerns, investigators conducted a study published in BMC Medicine that leverages data from the FDA Adverse Event Reporting System (FAERS) to evaluate the connection between semaglutide use and the occurrence of vision impairment.1
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Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is used to treat T2D with diet and exercise to help control blood sugar, along with lowering the risk of heart attack, stroke, or death in patients with obesity, heart or blood vessel disease, and T2D.2 In June 2021, a 2.4-mg dose of semaglutide was granted FDA approval for chronic weight management when used together with diet and exercise in adults with obesity or overweight with at least 1 weight-related condition, such as high blood pressure, T2D, or high cholesterol.3
Despite their well-documented metabolic benefits, emerging post-marketing surveillance data has raised questions regarding semaglutide’s ocular safety. Findings from a previous retrospective matched cohort study demonstrated an association between semaglutide use and an increased risk of nonatretic anterior ischemic optic neuropathy (NAION).1
Expanding on prior findings, the current study analyzed FAERS data up to June 2024 to assess the link with vision impairment. The study authors noted that reported odds ratios (rORs) were compared with vision impairment reports for semaglutide to other diabetes and weight loss drugs in T2D and obesity. Patients with both conditions were included in both analyses. The study also compared semaglutide to individual GLP-1 receptor agonists regarding specific vision issues—excluding optic neuritis.1
A total of 302,709 reports were analyzed by the researchers, including 17,853 mentioning obesity as an indication, 283,238 mentioning T2D, and 1,615 mentioning both conditions. Among the 11,558 reports for semaglutide, researchers recognized 417 cases directly related to visual impairment or ischemic optic neuropathy (ION).1
The results demonstrated that semaglutide has higher reporting compared to other GLP-1 receptor agonists (rOR 1.95; 95% CI 1.75–2.17, P < .0001). Additionally, the analysis revealed a more significant disparity in vision impairment reports when semaglutide was compared with other antidiabetic drugs, with an rOR of 2.46 (95% CI, 2.12–2.86, P < .0001) compared with DPP-4 inhibitors, an rOR of 3.89 (95% CI, 3.35–4.51, P < .0001) compared with SGLT2 inhibitors, and an rOR of 2.23 (95% CI, 1.90–2.62, P < .0001) compared with metformin.1
Compared with phentermine (Adipex-P, Lomaira) and orlistat (Alli, Xenical; GSK), semaglutide had higher reporting rates, with an rOR of 1.57 (95% CI, 1.07–2.31, P = .026) and 3.77 (95% CI, 2.96–4.81, P < .0001), respectively. In contrast, topiramate (Topamax; Janssen Pharmaceuticals) showed a higher rate of vision impairment reports than semaglutide, with an rOR of 0.30 (95% CI, 0.20–0.45, P < .0001).1
The findings suggest an elevated risk of vision impairment with semaglutide use compared with other weight loss and diabetes medications. However, the study authors noted that further clinical trials are needed to assess implications for treatment decisions and better understand the link between semaglutide and vision impairment.1
