Diabetes Treatment Can Lower Glaucoma Risk

Glucagon-like peptide-1 receptor (GLP-1R) agonists may help decrease the risk of glaucoma among patients with diabetes mellitus, according to a report published in the British Journal of Ophthalmology.

GLP-1R agonists, which regulate blood glucose, have been used to treat type 2 diabetes, which studies have shown is linked with higher risk of primary open-angle glaucoma (POAG). The investigators sought to determine whether GLP-1R agonists and new diagnosis of glaucoma were linked.

They collected data from a medical insurance claims database. Adult patients (n=1961) who began treatment with a GLP-1R agonist were included in the study, along with 4371 individuals in a control group who had begun treatment with an oral diabetic medication. The researchers excluded patients with a history of a glaucoma diagnosis from the study. Cohorts matched on age, sex, race, year of index date, and number of active diabetic medications.

The researchers balanced the cohorts’ baseline covariates using inverse probability of treatment weighting (IPTW).

They identified 58 new diagnoses of glaucoma or glaucoma suspect in the control group and 10 new diagnoses among the GLP-1R agonist cohort, indicating the latter group possessed a 0.56 hazard ratio (P =.01) for incident glaucoma.

In the first of 2 sensitivity analyses the researchers performed, they excluded glaucoma suspects. There was 1 new diagnosis of glaucoma in the group that received the GLP-1R agonist treatment, and 24 new diagnoses of glaucoma among control individuals (HR 0.08, P =.003).

In the second sensitivity analysis, the researchers matched the length of time each matched individual was included in the analysis. There were 3 more outcomes in the control group and a HR of 0.21 for glaucoma and glaucoma suspect in the group that received the agonist treatment (P <.001). Limitations included a lack of specific clinical data.

“While our results are exciting, we understand they comprise a single study in addressing the impact of GLP-1R agonists in glaucoma,” according to investigators. “However, given the favourable side effect profile of GLP-1R agonists, including low incidence of hypoglycaemia, and the availability of extensive safety data for this class of medications, our results provide at least a preliminary impetus for clinicians to preferentially consider GLP-1R agonists in treating patients with DM at high risk for glaucoma.”

Reference

Sterling J, Hua P, Dunaief JL, et al. Glucagon-like peptide 1 receptor agonist use is associated with reduced risk for glaucoma. Br J Ophthalmol. Published online August 19, 2021. doi:10.1136/bjophthalmol-2021-319232