Real-world study investigates effects of GLP-1 agonists on diabetic retinopathy
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ROME — There are conflicts in the literature concerning the association of Ozempic with increased risk or worsening of diabetic retinopathy.
A real-world analysis presented at the FLORetina-ICOOR meeting presented by Aleksandra Rachitskaya, MD, showed no significant difference in clinical worsening of DR between patients treated with Ozempic (semaglutide, Novo Nordisk) vs. a control group.
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Ozempic is a glucagon-like peptide 1 receptor agonist (GLP-1 RA) used in patients with diabetes type 2 to improve glycemic control. Increased rates of DR events in patients treated with Ozempic were reported in the SUSTAIN 6 trial, where a significantly higher rate of DR complications was found in the semaglutide-treated group as compared with placebo. Other large database trials showed no association between Ozempic and DR.
“We wanted to look at the real-world analysis. We did a retrospective study looking at our patients with diabetes who were started on this medication, and we also used as a control the sodium-glucose cotransporter 2 inhibitors (SGLT 2I) to see if there was a difference between these two groups,” Rachitskaya said.
A total of 981 patients were included, 692 of which were treated with GLP-1 RA and 289 with SGLT 2I. No significant difference was found between the two treatment groups in terms of DR worsening.
However, Rachitskaya explained that the study cohort had better baseline hemoglobin A1c and less improvement in glycemic control as compared with the SUSTAIN 6 study population. In several of the previous studies, most cases of DR worsening occurred in patients with higher HbA1c reduction and significant improvement in glycemic control. Because of this, Rachitskaya recommended close follow-up of those patients.
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Rachitskaya A. Diabetic retinopathy and GLP-1 receptor agonist. Presented at: FLORetina-ICOOR; November 30 – December 3, 2023; Rome, Italy.
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