The Mass. Eye and Ear-led study suggests semaglutides like Ozempic and Wegovy significantly increase risk of developing nonarteritic anterior ischemic optic neuropathy, a disease associated with sudden blindness.
The days of outrageously popular diabetes and weight loss semaglutides having their cake and eating it too might be over.
A matched cohort retrospective study1 out of Massachusetts Eye and Ear (Boston, USA) has found that the drugs, also known as glucagon-like peptide-1 receptor agonists (GLP-1 RA), exposed patients to a significantly higher risk of developing nonarteritic anterior ischemic optic neuropathy (NAION), a blinding disease.
Names like Ozempic, Wegovy (Novo Nordisk; Bagsværd, Denmark) and Zepbound (Eli Lilly and Company; Indianapolis, USA) have taken popular culture by storm with their reputation as a way to lose weight without serious side effects. This new research, published on July 3rd in JAMA Ophthalmology, seems to tip the scales in a different direction.
According to the study, overweight or obese patients were over seven times more likely to develop NAION [hazard ratio (HR) 7.64; 95% CI, 2.21-26.36; P < .001] over the 36-month study period. For type 2 diabetes, the risk for patients was just north of four times (HR 4.24; 95% CI, 1.62-11.29; P < .001).1
“The use of these drugs has exploded throughout industrialized countries and they have provided very significant benefits in many ways, but future discussions between a patient and their physician should include NAION as a potential risk,” said Dr. Joseph F. Rizzo of Mass. Eye and Ear, the lead study author.
The study was reportedly initiated when Mass Eye and Ear ophthalmologists noticed an unusual increase in cases of NAION, a notably rare disease. These patients had all been prescribed semaglutides.
NAION is a leading cause of irreversible blindness due to optic nerve damage, second only to glaucoma. Like glaucoma, early vision loss in NAION is both painless and difficult to detect until it progresses. But unlike most forms of glaucoma, NAION progresses quickly, leaving most patients in the dark with no treatment options.
The relative rarity of NAION also means that the vast majority of health care providers are not on the lookout for its presence—let alone possess the ability to diagnose it. Lead study author Dr. Joseph F. Rizzo III, director of the neuro-ophthalmology service at Mass. Eye and Ear and the Simmons Lessell Professor of Ophthalmology at Harvard Medical School, hopes that this study can change that.
“Our findings should be viewed as being significant but tentative, as future studies are needed to examine these questions in a much larger and more diverse population,” he said.
“This is information we did not have before and it should be included in discussions between patients and their doctors, especially if patients have other known optic nerve problems like glaucoma—or if there is pre-existing significant visual loss from other causes.”
Reference
- Hathaway JT, Shah MP, Hathaway DB, et al. Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide. JAMA Ophthalmol. 2024:e242296. [Epub ahead of print.]
