Semaglutide and diabetic retinopathy: an OHDSI network study.
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Cai Cindy Xinji, Nishimura Akihiko, Baxter Sally, Goetz Kerry, Hribar Michelle, Toy Brian, Barkmeier Andrew, Wang Sophia, Swaminathan Swarup, Flowers Alexis, Brown Eric, Xu Benjamin, Chen John, Chen Aiyin, Leng Theodore, Boland Michael, Alshammari Thamir, Bu Fan, Falconer Thomas, Martin Benjamin, Westlund Erik, Mathioudakis Nestoras, Zhang Linying, Fan Ruochong, Wilcox Adam, Lai Albert, Stocking Jacqueline C, Xie Yangyiran, Lee Lok Hin, Dorr David, Humes Izabelle, McCoy David, Adibuzzaman Mohammad, Areaux Raymond, Brash James, Weiskopf Nicole, Morgan-Cooper Hannah, Desai Priya, Tran Diep, Rustam Zainab, Zhu Gina, Swerdel Joel, Sena Anthony, Nagy Paul, Suchard Marc, Schuemie Martijn, Hripcsak George, Ryan Patrick
Аннотация
RESEARCH DESIGN AND METHODS: This was a retrospective cohort study of 14 databases (six administrative claims and eight electronic health records) in the Observational Health Data Sciences and Informatics Evidence Network. Adults with T2D on semaglutide, other GLP-1RA (dulaglutide, exenatide), or non-GLP-1RA medications (empagliflozin, sitagliptin, glipizide) from 1 December 2017 to 31 December 2023 were included. The association between semaglutide and PDR or treatment-requiring DR/DME was assessed using an active-comparator cohort design comparing new users of semaglutide as second-line T2D treatment to those on other GLP-1RAs and non-GLP-1RAs. Propensity score-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs). Network-wide HR estimates were generated using a random-effects meta-analysis.
RESULTS: The study included 810 390 new semaglutide users for T2D. PDR risk for semaglutide was similar to dulaglutide (HR 0.81, 95% CI 0.42 to 1.54, p=0.51), empagliflozin (HR 0.83, 95% CI 0.53 to 1.30, p=0.41) and sitagliptin (HR 0.83, 95% CI 0.45 to 1.55, p=0.57) but was lower than glipizide (HR 0.59, 95% CI 0.39 to 0.88, p=0.01). The risk for treatment-requiring DR/DME for semaglutide was similar to empagliflozin (HR 0.66, 95% CI 0.43 to 1.02, p=0.06) but lower than dulaglutide (HR 0.53, 95% CI 0.31 to 0.91, p=0.02), sitagliptin (HR 0.46, 95% CI 0.26 to 0.81, p=0.008) and glipizide (HR 0.55, 95% CI 0.33 to 0.91, p=0.02).
CONCLUSIONS AND RELEVANCE: We did not identify increased risk for either PDR or treatment-requiring DR/DME comparing semaglutide with other GLP-1RAs or non-GLP-1RAs. Patients with T2D should still undergo close eye care follow-up, particularly when initiating new antihyperglycemic medications.