USA: GLP-1R Agonists and Glaucoma Risk

The use of glucagon-like peptide 1 receptor (GLP-1R) agonist significantly lowers hazard reduction for a new diagnosis of glaucoma. The findings, published in the British Journal of Ophthalmology, support the use of glucagon-like peptide 1 receptor (GLP-1R) agonists in glaucoma prevention.

Glucagon-like peptide 1 receptor (GLP-1R) agonists regulate blood sugar levels and are commonly used for the treatment of type 2 diabetes (T2D). Recent studies have shown treatment with the glucagon-like peptide 1 receptor (GLP-1R) agonist NLY01 to be associated with decreased retinal neuroinflammation and glial activation to rescue retinal ganglion cells in a mouse model of glaucoma.

Against the above background, Brian L VanderBeek, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA, and colleagues aimed to examine whether GLP-1R agonist exposure impacts glaucoma risk using an insurance claims database.

A retrospective cohort of patients who initiated a new GLP-1R agonist was 1:3 age, gender, race, classes of active diabetes medications, and year of index date matched to patients who initiated a different class of oral diabetic medication. To test the association between GLP-1R agonist exposure and a new diagnosis of primary open-angle glaucoma, glaucoma suspect, or low-tension glaucoma, inverse probability of treatment weighting (IPTW) was used within a multivariable Cox proportional hazard regression model.

Cohorts were comprised of 1961 new users of GLP-1R agonists matched to 4371 unexposed controls.

Study Findings

• After IPTW, all variables were balanced (standard mean deviation <|0.1|) between cohorts.
• Ten (0.51%) new diagnoses of glaucoma were present in the GLP-1R agonist cohort compared with 58 (1.33%) in the unexposed controls.
• After adjustment, GLP-1R exposure conferred a reduced hazard of 0.56, suggesting that GLP-1R agonists decrease the risk for glaucoma.

"The use of GLP-1R agonist was associated with a statistically significant hazard reduction for a new diagnosis of glaucoma," wrote the authors. "Our findings support further investigations into the use of GLP-1R agonists in glaucoma prevention."

Reference

The study titled, "Glucagon-like peptide 1 receptor agonist use is associated with reduced risk for glaucoma," is published in the British Journal of Ophthalmology.

DOI: https://bjo.bmj.com/content/early/2021/08/18/bjophthalmol-2021-319232