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EL NUEVO DIARIO, Scientific Editorial. – People who take semaglutide (Ozempic and Wegovy), a drug used to treat diabetes and lose weight, are at greater risk of developing a rare form of blindness, a study has confirmed.
A disease of the optic nerve called nonarteritic anterior ischemic optic neuropathy (Noiana) may be behind this, which can lead to blindness. The work was led by Joseph Rizzo, a professor at Massachusetts Eye and Ear Infirmary and Harvard Medical School; the findings were published in the journal JAMA Ophthalmology.
Specifically, the observational, noncausal study found that people with type 2 diabetes who were prescribed semaglutide by their doctors were more than four times as likely to be diagnosed with Noiana; and more than seven times as likely to be overweight or obese.
“The use of these drugs has exploded in all industrialized countries, and they provide very significant benefits in many ways, but future conversations between patients and doctors have to consider Noana as a potential risk,” Rizzo said, especially if the patient has other known optic nerve problems, such as glaucoma.
However, it is important to remember that the increased risk is associated with a relatively rare disease, the researchers cautioned in a statement from Mass Eye and Ear, a Harvard Medical School teaching hospital.
Noah’s disease is relatively rare, affecting about 10 per 100,000 people in the general population; it is the second leading cause of optic blindness (after glaucoma).
The study began in late summer 2023. Mass Eye and Ear neuro-ophthalmologists noted that in just one week, three patients were diagnosed in their practice with this relatively rare disease that causes vision loss; all three were taking semaglutide, the doctors noted.
This led the team to conduct a retrospective analysis of the patient population to see if they could identify a relationship.
The researchers analyzed the records of 16,827 patients who were treated over a six-year period and divided them into those who were diagnosed with diabetes or were overweight/obese.
The researchers compared patients taking semaglutide with those taking other medications for diabetes or weight loss. They then analyzed the rates of NoA diagnosis in the two groups and the results showed an increased risk.
For patients with type 2 diabetes (194 patients treated with semaglutide and 516 patients treated with other types of drugs), 17 cases of Noiana were diagnosed in those taking semaglutide and six in the other group. The cumulative incidence over three years was 8.9% and 1.8%, respectively.
Among the overweight and obese population (361 receiving semaglutide and 618 receiving other treatments), there were 20 Noiana events and only 3. The cumulative incidences over three years were 6.7% and 0.8%, respectively.
Limitations of the study
Mass Eye and Ear cares for an unusually high number of patients with rare eye diseases, the study population was overwhelmingly white, and a relatively small number of Noyana cases were observed during the six-year study period.
The researchers were also unable to determine whether patients actually took semaglutide or stopped taking it at some point, or how that might have affected their risk.
Importantly, the study does not prove cause and effect, and the researchers do not know why or how the association exists or why there were differences between the diabetic and overweight groups.
Rizzo stressed that “our findings should be considered important but tentative, as future studies are needed to examine these issues in larger, more diverse populations.”
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