Weight Loss Drugs and Eye Health Risks
Recent research has revealed a concerning link between weight loss medications and an increased risk of age-related macular degeneration in diabetic patients. A large-scale study indicates that individuals using glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications may double their chances of developing this eye condition.
Originally aimed at managing diabetes, GLP-1 RA drugs have revolutionized obesity treatment and are showing promising additional health advantages. These medications assist in lowering blood sugar levels, delaying digestion, and curbing appetite.
However, Canadian researchers published findings in Jama Ophthalmology indicating that after six months on GLP-1 RAs, older adults with diabetes have twice the risk of developing neovascular age-related macular degeneration compared to similar patients not taking these drugs.
At the University of Toronto, a study involving over a million diabetes patients in Ontario pinpointed 46,334 individuals averaging 66 years old who were prescribed GLP-1 RAs. Notably, 97.5% of these patients were on semaglutide, while the remaining 2.5% were on lixisenatide.
The study included various brands but noted that since Wegovy was only approved in Canada in late 2021 for weight loss, most semaglutide users were likely prescribed Ozempic, which is intended for diabetes treatment.
Researchers matched each patient on semaglutide or lixisenatide with two others who had diabetes but were not on the drugs, considering similar demographics and health statuses. Over three years, they tracked the incidence of neovascular age-related macular degeneration between these groups.
Results showed that those on GLP-1 RAs for at least six months had double the risk of developing macular degeneration compared to those not on the drugs. In fact, after more than 30 months, the risk elevated to more than three times that of the non-user group.
Additionally, older diabetic patients or those with a history of strokes faced an even greater risk of developing this eye condition while on these medications.
Marko Popovic, a co-author and ophthalmology physician at the University of Toronto, expressed caution regarding GLP-1 RAs, suggesting that they might adversely affect the eye, particularly in the case of neovascular age-related macular degeneration.
“Based on our findings, I would highly recommend careful consideration when prescribing GLP-1 RAs to older diabetic patients or those with prior strokes, as both groups are at a significantly elevated risk,” he noted.
An editorial by Brian VanderBeek from the University of Pennsylvania highlighted the possibility that many patients might be impacted by these findings. He estimated that around one in 1,000 users of GLP-1 RAs could develop new age-related macular degeneration compared to unexposed individuals, suggesting a concerning potential number if the risk extends across millions of users.
VanderBeek emphasized the need for further investigation to determine if this risk extends beyond diabetics to those using these medications for other conditions like weight management. “While the benefits of these medications are significant, it’s vital for prescribing physicians to be aware of potential serious eye-related complications,” he added.
A representative from Novo Nordisk, which produces Ozempic and Wegovy, reassured that patient safety remains a priority and that they keep a close watch on any reported adverse events. They mentioned that extensive trials to date have not shown a significant difference in the onset of macular degeneration related to these medications.
Dr. Alison Cave, chief safety officer of the UK’s Medicines & Healthcare products Regulatory Agency, stated that macular degeneration is not currently listed as a potential side effect of GLP-1 RAs. However, she acknowledged that ongoing research is vital and the agency continually reviews the safety of these medications, emphasizing that for now, their benefits outweigh the risks when used as intended.
