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GLP-1 receptor agonists and diabetic retinopathy: A meta-analysis of randomized clinical trials
Journal article   Peer reviewed

GLP-1 receptor agonists and diabetic retinopathy: A meta-analysis of randomized clinical trials

Ishani Kapoor, Swara M. Sarvepalli, David D'Alessio, Dilraj S. Grewal and Majda Hadziahmetovic
Survey of ophthalmology, v 68(6), pp 1071-1083
01 Nov 2023
PMID: 37454782

Abstract

Adverse events Glucagon-like peptide-1 receptor agonists Meta-analysis Type 2 diabetes mellitus Diabetic Retinopathy
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are used to treat type 2 diabetes mellitus. Recent research suggests that GLP-1 RAs may influence diabetic retinopathy (DR). We searched ClinicalTrials.gov for trials comparing FDA-approved GLP-1 RAs to placebo, insulin, or oral antidiabetic medicine. Rates of DR, ocular adverse events, demographics, and clinical characteristics were compared amongst cohorts on 93 trials. GLP-1 RA use was significantly associated with increased risk of early-stage DR (risk ratio (RR) = 1.31, 95% confidence interval (CI) [1.01, 1.68]) and early-stage retinal adverse events (RR = 1.29, 95% CI [1.01, 1.66]) compared to placebo. Compared to insulin, GLP-1 RA use protected against late-stage DR (RR = 0.38, 95% CI [0.15, 0.98]). Analysis of individual GLP-1 RAs showed that albiglutide is responsible for these trends, as it is significantly associated with a higher risk of early-stage DR (RR = 2.18, 95% CI [1.01, 4.67]) compared to placebo and a lower risk of late-stage DR (RR = 0.25, 95% CI [0.09, 0.70]) compared to insulin. Albiglutide similarly affected retinal and ocular adverse events. Demographic analysis revealed significant differences between GLP-1 RA and comparator groups for age, HbA1c, body weight, BMI, duration of diabetes, sex, race, and ethnicity. The influence of GLP-1 RAs on DR and the eye may depend on the specific GLP-1 RA and patient demographic and clinical characteristics.

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Collaboration types
Domestic collaboration
Web of Science research areas
Ophthalmology
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