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People taking weight loss and diabetes drugs such as Ozempic and Wegovy may be at greater risk of sudden and irreversible vision loss and blindness, a new study finds.
However, doctors say patients taking these popular medications do not need to panic or stop taking their prescribed drugs.
The study, conducted by Harvard researchers and published Wednesday in JAMA Ophthalmologyanalyzed data from 16,827 patients over a six-year period at Harvard’s Mass Eye and Ear teaching hospital.
Of these, 710 had type 2 diabetes, and 194 were prescribed semaglutide drugs, which are marketed under brand names such as Wegovy and Ozempic and belong to a class of drugs known as GLP-1 receptor agonists.
Another 975 patients in the study were overweight or obese, of whom 361 were prescribed semaglutide.
Among the prescribed drugs, semaglutide is an eye problem known as non-arteritic anterior ischemic optic neuropathy, or NAIONwas eventually diagnosed in a small percentage of patientsNone of the more than 16,000 patients were initially diagnosed with NAION.
After taking into account patients’ other risk factors for the condition, such as high blood pressure and obstructive sleep apnea, semaglutide use was associated with a more than fourfold increased risk of heart attack. higher risk of NAION in patients taking the drug for diabetes and a more than seven-fold increased risk in patients taking the drug for weight problems.
Research found that 8.9 percent of patients taking semaglutide for type 2 diabetes developed NAION, compared to 1.8 percent of patients taking non-GLP-1 medications.
In 6.7 percent of patients prescribed semaglutide for overweight or obesity, the rate of eye disorders was 0.8 percent, while in patients given other types of weight loss medications it was 0.8 percent.
NAION affects the optic nerve, the bundle of fibers that connects to the back of the eye and carries signals to the brain that make vision possible. People with NAION have reduced or blocked blood and oxygen flow to the optic nerve – a type of painless eye stroke that can result in sudden vision loss.
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The study found that the risk of developing NAION greatest within the first year after prescribing semaglutidebut researchers say their findings should be considered “preliminary” for now.
“The use of these drugs has exploded in industrialized countries and they have shown very significant benefits in many ways, but future discussions between a patient and their physician should include NAION as a potential risk,” said lead investigator Dr. Joseph Rizzo, director of neuro-ophthalmology at Mass Eye and Ear and a professor at Harvard Medical School, in a press release.
“Our findings should be viewed as significant but preliminary, as future studies are needed to examine these questions in a much larger and more diverse population.”
Dr. Tom Elliott, Medical Director at BC Diabetestold Global News he is already receiving emails from concerned patients about the study and called the association between the drug and the cause of blindness “extremely rare.”
“It’s not that they’re saying Ozempic causes this problem,” he explained. “It’s just that it’s more common in people who use the drug.”
Elliott says he reassures his patients that if they have a good reason to take semaglutide, “the benefits far outweigh the risks” and that the drugs can be “tremendously beneficial.”
He says semaglutide drugs are not only helpful in managing diabetes and weight, but also in heart and blood vessel health. The potential risk of NAION should not deter people from taking semaglutide if they really benefit from it.
“In people with previous heart attacks and strokes, (these drugs) reduce the risk of death by 20 percent. So in people who haven’t had these events… the overall benefits for diabetes, weight and cardiovascular risk are quite significant.”
Another factor in the study that needs to be considered, says Dr. Mark Eltis, president of the Ontario College of Optometristsis that untreated diabetes can also lead to vision problems.
“If we don’t treat diabetes, the blood vessels at the back of the eye can start to leak, or new blood vessels can form that aren’t as stable as the normal blood vessels because they’re not supposed to be there. So they can collapse more easily and cause bleeding or hemorrhaging at the back of the eye.”
While NAION is the second most common optic nerve disorder, Eltis says it is a “distant second” to glaucoma. What sets the two apart, however, is that NAION causes sudden vision loss, while glaucoma tends to be a more gradual disease where vision worsens over time.
Novo Nordisk noted in an emailed statement to Reuters several limitations of the research designthat it was not a randomized controlled trial, and noted that the study did not take into account potentially relevant information, such as how long patients had diabetes or whether they were smokers.
“Overall, the data published in the study are not sufficient to establish a causal relationship between the use of GLP-1 receptor agonists and NAION,” said the Danish drugmaker, which produces Wegovy and Ozempic, adding that the condition “is not a side effect of the marketed formulations of semaglutide.”
It is worth noting that the Canadian warnings for both Ozempic and Wegovy list changes in vision as possible side effects.
Eltis says anyone considering taking semaglutide should talk to their doctor about the risks and benefits of treatment and should also be assessed for any eye conditions so that an individual plan can be developed.
“You can’t leave diabetes untreated. That’s not the way to go. Every treatment has a risk and a benefit, and many of these should not be taken out of context because they have a low probability.”
— with files from Reuters
© 2024 Global News, a division of Corus Entertainment Inc.
Michelle Butterfield
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