Association between Glucagon-like Peptide-1 Receptor Agonists and the Risk of Glaucoma in Individuals with Type 2 Diabetes

• Published in: Ophthalmology (Rochester, Minn.) Vol. 131; no. 9; pp. 1056 - 1063
• Main Authors: Niazi, Siar, Gnesin, Filip, Thein, Anna-Sophie, Andreasen, Jens R., Horwitz, Anna, Mouhammad, Zaynab A., Jawad, Baker N., Niazi, Zia, Pourhadi, Nelsan, Zareini, Bochra, Meaidi, Amani, Torp-Pedersen, Christian, Kolko, Miriam
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2024
• Subjects: Adult; Aged; Antihyperglycemic medication; Case-Control Studies; Danish; Diabetes Mellitus, Type 2 - drug therapy; Female; Glaucoma; Glaucoma - chemically induced; Glaucoma - drug therapy; Glaucoma - epidemiology; Glucagon-like peptide-1 receptor agonists; Glucagon-Like Peptide-1 Receptor Agonists - administration & dosage; Glucagon-Like Peptide-1 Receptor Agonists - adverse effects; Humans; Incidence; Male; Metformin - administration & dosage; Middle Aged; Nationwide; Risk Factors; Type 2 diabetes; Glaucoma; Type 2 diabetes; SGLT2; CI; HR; Glucagon-like peptide-1 receptor agonists; IOP; Nationwide; ATC; DPP4; Danish; GLP-1RA; Antihyperglycemic medication
• ISSN: 0161-6420; 1549-4713; 1549-4713
• DOI: 10.1016/j.ophtha.2024.03.004

To examine the association between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and the development of glaucoma in individuals with type 2 diabetes. Nationwide, nested case-control study. From a nationwide cohort of 264 708 individuals, we identified 1737 incident glaucoma cases and matched them to 8685 glaucoma-free controls, all aged more than 21 years and treated with metformin and a second-line antihyperglycemic drug formulation, with no history of glaucoma, eye trauma, or eye surgery. Cases were incidence-density–matched to 5 controls by birth year, sex, and date of second-line treatment initiation. Conditional logistic regression was used to calculate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for glaucoma, defined by first-time diagnosis, first-time use of glaucoma-specific medication, or first-time glaucoma-specific surgical intervention. Compared with the reference group, who received treatments other than GLP-1RA, individuals who were exposed to GLP-1RA treatment exhibited a lower risk of incident glaucoma (HR, 0.81; CI, 0.70–0.94; P = 0.006). Prolonged treatment extending beyond 3 years lowered the risk even further (HR, 0.71; CI, 0.55–0.91; P = 0.007). Treatment with GLP-1RA for 0 to 1 year (HR, 0.89; CI, 0.70–1.14; P = 0.35) and 1 to 3 years (HR, 0.85; CI, 0.67–1.06; P = 0.15) was not significant. Exposure to GLP-1RA was associated with a lower risk of developing glaucoma compared with receiving other second-line antihyperglycemic medication. Proprietary or commercial disclosure may be found after the references.