Representative image: Semaglutide is sold under the brand names Wegovy, Rybelsus, and Ozempic by the Danish pharmaceutical manufacturer Novo Nordisk.
Semaglutide, a new class of antidiabetic drugs gaining popularity worldwide, may be linked to a potential risk of vision loss, according to a study conducted by Boston researchers and published in the medical journal JAMA Ophthalmology.
The semaglutide market size is estimated to reach $27.55 billion in 2024 and is expected to reach $50.34 billion by 2029, with a compound annual growth rate (CAGR) of 12.8 percent. Semaglutide is sold under the brand names Wegovy, Rybelsus, and Ozempic by Danish pharmaceutical major Novo Nordisk.
The study, titled ‘Risk of non-arteritic anterior ischemic optic neuropathy in patients prescribed semaglutide’, suggested that continuous use of semaglutide (a glucagon-like peptide 1 receptor agonist, or GLP-1RA) may be linked to the development of a condition called non-arteritic ischemic optic neuropathy (NAION). NAION, the study claimed, is the second most common form of optic neuropathy and a leading cause of blindness in adults. The incidence of NAION is 2-10 cases per 100,000 people. “Our anecdotal clinical experience motivated us to investigate whether semaglutide is associated with an increased risk of developing NAION,” the authors wrote.
The authors – Jimena Tatiana Hathaway, Madhura P Shah, David B Hathaway and others – are affiliated with several institutions in Boston, including Harvard TH Chan School of Public Health, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston.
The researchers also noted that this was an observational study and therefore further research is needed to establish causality.
The matched cohort study of 16,287 patients showed an increased risk of NAION in patients prescribed semaglutide compared with patients prescribed non-GLP-1 RA medications for diabetes or obesity. “The findings suggest a potential risk of NAION associated with semaglutide prescriptions, but future research is needed to assess causality,” the authors wrote.
Of the 16,827 patients, 710 had type 2 diabetes (194 prescribed semaglutide; 516 prescribed non-GLP-1 RA medications). The median age was 59 years; 52 percent were female; and 979 were overweight or obese. In the type 2 diabetes population, there were 17 NAION events in patients prescribed semaglutide versus six in the non-GLP-1 RA cohort. Over a 36-month period, the cumulative incidence rates of NAION were 8.9 percent for the semaglutide group.
The analysis found that patients treated with semaglutide had a higher risk of developing NAION compared with patients receiving non-GLP-1 RA medications. Among overweight or obese patients, 20 NAION events were reported in the semaglutide group versus three in the non-GLP-1 RA cohort, resulting in a cumulative incidence rate of 6.7 percent over 36 months.
Semaglutide (Ozempic; Novo Nordisk) was approved by the U.S. Food and Drug Administration (FDA) in December 2017 for the treatment of type 2 diabetes and in December 2022 for the treatment of obesity (usually in higher doses, such as Novo Nordisk’s Wegovy).
The researchers noted that the number of weekly prescriptions for new brands of these and other GLP-1 RA medications in the United States increased by about 60 percent between 2021 and 2023.
Doctors have said that more data is needed before conclusions can be drawn. Anoop Misra, chairman of Fortis C-Doc Hospital for Diabetes and Allied Sciences, said: “The risk of non-arteritic anterior ischemic optic neuropathy has been shown to increase in patients prescribed semaglutide in an observational study. Keep in mind that more data are needed in better conducted studies. In my experience of over 1,000 patients treated, no such cases have been observed.”
Semaglutide is a new class of diabetes drugs in the GLP-1 RA category
The semaglutide market size is estimated to reach USD 27.55 billion in 2024 and is expected to reach USD 50.34 billion by 2029, with a CAGR of 12.8 percent.
The study (matched cohort study) of 16,287 patients found that the risk of NAION was higher in patients prescribed semaglutide compared to patients prescribed non-GLP 1 RA drugs for diabetes or obesity.
NAION is the second most common form of optic neuropathy and is also a leading cause of blindness in adults.
First print: Jul 14, 2024 | 10:45 AM IST