Purchase this article with an account.
Qi N Cui, Jacob Sterling, Peiying Hua, Joshua L Dunaief, Brian L VanderBeek; Exposure to glucagon-like peptide 1 receptor (GLP1R) agonists is associated with reduced risk for glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1013.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Glucagon-like peptide-1 receptor (GLP1R) agonists regulate blood glucose and are commonly used to treat type II diabetes. Recent work by our group showed that treatment with the novel GLP1R agonist NLY01 mitigated neuroinflammation and decreased glial activation to rescue retinal ganglion cells in an animal model of glaucoma (PMID 33147455). In this study, we used insurance claims data to examine whether GLP1R agonists impacted glaucoma risk.
A retrospective cohort of adult patients who initiated a new GLP1R agonist (i.e. exenatide, liraglutide, albiglutide, dulaglutide, semaglutide, or lixisenatide) was 1:3 age, gender, race, classes of active diabetes medication, and year of index date matched to a cohort of patients who initiated a different class of oral diabetic medication during their time in the database. Exclusion occurred for < 2 years in the database, < 18 years old, failure to visit an eyecare provider prior to the index date, a prior diagnosis of glaucoma, glaucoma suspect, or ocular hypertension, and prior glaucoma medication, procedure, or surgery. Primary outcome was a new diagnosis of primary open angle glaucoma, glaucoma suspect, or low tension glaucoma. Diabetes severity was assessed using hemoglobin A1c and the Diabetes Complications Severity Index (DCSI), a validated metric based on six categories of diabetic complications. Inverse probability of treatment weight (IPTW) was used within a multivariable Cox proportional hazard regression model to test the association between exposure to GLP1R agonists and the primary outcome. IPTW was derived from a propensity score model based on the DCSI, HbA1c, demographic factors, and other systemic health conditions.
Cohorts were comprised of 1961 new users of GLP1R agonists matched to 4371 unexposed controls. After IPTW, age was the only imbalanced covariate between cohorts (SMD > 0.1). Ten new diagnoses of glaucoma (0.51%) were present in the GLP1R agonist cohort compared to 58 (1.33%) in the unexposed controls, conferring a reduced hazard of 0.54 (95%CI: 0.35-0.85, p=0.007) among GLP1R agonist initiators, suggesting that GLP1R agonists reduced the risk for glaucoma.
GLP1R agonists were associated with a statistically significant hazard reduction for a new glaucoma diagnosis. Our findings support further investigations into the use of GLP1R agonists in glaucoma prevention.
This is a 2021 ARVO Annual Meeting abstract.
This PDF is available to Subscribers Only