Analysis of more than 300 million patient records suggests the apparent association between GLP-1 medicines and age-related macular degeneration may largely reflect underlying cardiometabolic conditions.
At the annual meeting of the American Academy of Ophthalmology in New Orleans, researchers presented evidence suggesting that the apparent link between glucagon-like peptide-1 receptor agonists and age-related macular degeneration depends heavily on how the data are analysed. A report carried by Drugs.com from HealthDay said crude results pointed to higher odds of AMD among people taking the drugs, but that association disappeared, and in some cases reversed, once common cardiometabolic risk factors were taken into account.
The study, led by Franklin Ye Ruan of the Carle Illinois College of Medicine in Urbana, examined more than 300 million patients in Epic Cosmos, a large health data set. Among 300,410,753 patients, 15,385,073 had been exposed to a GLP-1 receptor agonist, 1,384,467 had AMD and 115,056 had both. Before adjustment, the reported odds ratios suggested greater risk for any AMD, dry AMD and wet AMD. But after accounting for type 2 diabetes, hypertension and hyperlipidaemia, the direction of the association changed for any AMD and wet AMD, while adjustment for body mass index reduced the signal. Age, meanwhile, pushed the odds ratios higher.
The findings add to a complicated and at times conflicting body of research. A study in JAMA Ophthalmology found GLP-1 receptor agonist use was associated with a lower risk of non-exudative AMD over 10 years compared with other weight-loss drugs, though it did not find a meaningful difference in progression to exudative AMD. By contrast, a separate JAMA Ophthalmology cohort study reported a substantially higher estimated risk of neovascular AMD among patients with diabetes exposed to these medicines. Healthline has also reported on research suggesting a higher risk of wet AMD with longer use of GLP-1 drugs, particularly semaglutide.
A systematic review in the Canadian Journal of Ophthalmology said the ocular safety profile of GLP-1 receptor agonists remains uncertain and called for stronger studies. Ruan said in a statement that the hope is the latest findings will push researchers towards more rigorous work that accounts properly for underlying health conditions. For now, the evidence suggests that any relationship between these widely used diabetes and weight-loss medicines and macular degeneration is unlikely to be simple, and may vary depending on the patient population studied and the statistical method used.
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