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TOPLINE:

A large study across multiple health databases found patients with type 2 diabetes taking semaglutide were neither more nor less likely to develop neovascular age-related macular degeneration than were those taking other diabetes medications.

METHODOLOGY:

• Researchers conducted a retrospective study across 12 databases in the Observational Health Data Sciences and Informatics network from December 2017 to December 2024 to investigate the potential association between use of semaglutide and neovascular age-related macular degeneration.
• The study used an active-comparator new-user cohort that compared semaglutide initiators with matched initiators of other GLP-1 receptor agonists (dulaglutide and exenatide) and certain non-GLP-1 drugs (empagliflozin, glipizide, and sitagliptin) and a self-controlled case series that compared each patient’s risk during periods of drug exposure vs nonexposure.
• A total of 227,971 new users of semaglutide, 68,588 of dulaglutide, 5460 of exenatide, 252,356 of empagliflozin, 100,083 of sitagliptin, and 213,515 of glipizide were included before propensity score adjustment; all were adults with type 2 diabetes who received these medications as second-line treatment after metformin monotherapy.
• Two definitions of neovascular age-related macular degeneration were applied: a diagnosis-only definition for patients older than 55 years that excluded those with other retinal conditions, and a stricter definition that required a diagnosis plus an injection into the eye of an anti-vascular endothelial growth factor medication within 30 days to indicate active disease.

TAKEAWAY:

• Among new semaglutide users, 70-79 people met the diagnosis-only definition of neovascular age-related macular degeneration, and 39-51 met the stricter definition requiring diagnosis plus injection.
• Semaglutide users showed no statistically significant difference in the risk for neovascular age-related macular degeneration compared with dulaglutide users (diagnosis-only, P = .28; diagnosis-plus-injection, P = .10), empagliflozin users (diagnosis-only, P = .94; diagnosis-plus-injection, P = .52), sitagliptin users (diagnosis-only, P = .09; diagnosis-plus-injection, P = .33), and glipizide users (diagnosis-only, P = .69; diagnosis-plus-injection, P = .12).
• Among patients with neovascular age-related macular degeneration included in the self-controlled analysis, no increased incidence of the condition was observed during periods of semaglutide exposure compared with nonexposure (P > .5 for both definitions of neovascular age-related macular degeneration).

IN PRACTICE:

“Our study contributes an important finding to the literature by showing that semaglutide is not associated with a large increased risk nor a decreased risk” for neovascular age-related macular degeneration, at least among patients with type 2 diabetes, the researchers of the study reported.

Although previous studies have found such a link, including one that showed more than a doubling of the risk, “[t]he CIs of our estimates suggest that such a large, harmful effect is unlikely,” they added. “However, our findings do not refute a small effect in either direction, including prior studies that have found a small positive association.”

SOURCE:

The study was led by Cindy X. Cai, MD, MS, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore. It was published online on May 21 in Ophthalmology.

LIMITATIONS:

Because the study was retrospective and relied on diagnosis and procedure codes, it is uncertain how accurately those codes capture patients’ true clinical conditions. Although the overall sample was large, the number of patients who developed neovascular age-related macular degeneration was relatively small. The analysis did not examine whether the risk associated with semaglutide or other medications differed by age or other patient subgroups.

DISCLOSURES:

Some authors disclosed receiving grants from the National Eye Institute, the Research to Prevent Blindness Career Development Award, the Jonathan and Marcia Javitt Professorship, and other sources. Some also reported having industry relationships, including grant or equipment support, contracts, consulting fees, advisory roles, employment, or shareholdings with pharmaceutical and medical device companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.