The semaglutide is a drug initially developed as antidiabetic. It is also used for long -term weight management in patients with severe obesity. Research has however suggested a link between taking semaglutide (or assimilated drug) and an increased risk of developing a serious eye condition that can cause blindness. Researchers American So have undertaken to study further the effects of semaglutide on eye diseases in people with type 2 diabetes.
Semaglutide is a similar analog glucagon-like peptide-1 (GLP-1), a hormone secreted naturally by intestinal cells during meals. This molecule contributes to the feeling of satiety. It is the active principle of the Ozempic and the Wegovy. The first helps regulate blood sugar. It is prescribed in case of insufficiently controlled diabetes. The second, which benefited from an “early access” authorization, is indicated in chronic weight management.
The shooting has been marketed in France since November 2024 under the name of Mounjaro. It also aims to treat type 2 diabetes and obesity in adults. It is an agonist of GLP-1 and the GIP (insulinotropic polypeptide dependent on glucose)-a hormone which stimulates the secretion of insulin. It would be even more effective than semaglutide. However, these two GLP-1 agonists are accompanied by several undesirable effects: gastrointestinal disorders, hypoglycemia, fatigue, etc. Research has suggested that they could also lead to a decrease in heart mass, as well as serious eye complications.
Cases of optical neuropathy increasing
The semaglutide has been the subject of several randomized controlled trials worldwide before its marketing. There Food and Drug Administration American has approved its use in 2017. The Ozempic has been authorized throughout the European Union since February 2018. Millions of people worldwide are taking this medication today.
But last year, an American study suggested for the first time that patients under semaglutide could present a higher risk of developing anterior non-arteric ischemic optical neuropathy (Noia-NA). This condition occurs when the blood flow towards the optic nerve decreases. This causes a sudden, partial and permanent loss of vision. Note that the authors of the study could not establish any cause and effect link. They nevertheless called for “post-marketing monitoring”.
>> Read also: researchers find the cause of “the yo-yo effect” of slimming diets
Intrigued by this potential association, Danish researchers have verified if follow -up studies, on larger cohorts, made it possible to confirm the hypothesis. In Denmark, more than 106,000 diabetic patients have ozempic. Two independent studies, carried out by the University of Southern Denmark, have reached the same conclusion as the American study.
The first study, involving more than 420,000 Danish with type 2 diabetes, said that taking Ozempic multiplies by two the risk of developing a Noia-Na (compared to other treatments)! “” At the same time, in the clinic, we have found that since the marketing of Ozempic in 2018, the number of cases of Noia-Na in Denmark has increased “Adds Jakob Grauslund, professor of ophthalmology, who led the study.
The second study, conducted in collaboration with the Norwegian Public Health Institute, involved Danish and Norwegian patients. All started with ozempic treatment or other drug treatment. Again, the researchers found that the risk of developing a Noia-Na is double with the Ozempic.
No evidence of a cause and effect link
The authors of these two Danish studies nevertheless recall that this optical neuropathy remains an extremely rare side effect. “” Neither more serious nor more frequent than the rare side effects of many other drugs “, Specifies Anton Pottegård, who led the second study. On the other hand, in the absence of treatment, diabetes can cause other eye disorders (diabetic retinopathy, cataract, glaucoma) much more frequent.
The use and effects of Ozempic and other GLP-1 agonists are still under close surveillance. Thus, researchers from John A. Moran Eye Centerfrom the University of Utah, recently published an investigation report on nine patients who developed pathologies affecting the optic nerve while they took semaglutide or shooting.
>> Read also: obesity: the point on the risks and benefits of the Wegovy
Among the patients involved, seven presented a Noia-Na. Another suffered from bilateral papillitis (inflammation of the eye taste buds, located at the bottom of the eye, at the head of the optic nerve). The last presented a acute paracentral median maculopathy (a pathology affecting the retina). In addition, some patients had atypical symptoms. For example, while Noia-Na generally leads to a brutal decrease in visual acuity, the loss of vision was progressive in certain patients.
The authors of the study could not establish a causal link between drugs and the ophthalmic complications reported. However, they argue that the latter could rather result from the rapid correction of hyperglycemia induced by these drugs, rather than a toxic effect of the drugs themselves.
“” Other studies are necessary to verify our hypothesis. However, this is an important question for ophthalmologists, as we monitor the use of these drugs and the best way to communicate with our patients on this subject “Said Dr. Bradley Katz, a neuro-speaking specialist and the main study of the study.
Long -term risks still studying
As mentioned above, type 2 diabetes can itself lead to multiple complications (metabolic, arterial and neuropathic). The most common ocular complication is diabetic retinopathy, which slowly evolves without symptoms. In the long term, it can lead to a progressive loss of sight. Patients under semaglutide or shooting should therefore not interrupt their treatment. At least, not without having previously discussed it with their doctor.
Of course, in the event of a sudden loss of vision, an emergency medical consultation is essential. If necessary, the doctor may prescribe alternative treatment, via which blood sugar variations are less “sudden”.
“” Due to the association of the semaglutide with a temporary worsening of diabetic retinopathy, the increased incidence of diabetic macular edema and the fear that a rapid correction of hyperglycemia does not induce papillitis, the doctors who prescribe this medication to their patients with type 2 diabetes should consider a drug diet which more gradually reduces the HBA1C level [ndlr : l’hémoglobine glyquée] “, Advise the authors of the study in Jama ophthalmology.
>> Read also: Alzheimer's, addictions, depression … The beneficial effects of ozempic and related drugs
Ultimately, several questions remain in the long-term efficiency and the risks of antidiabetics of the GLP-1 type. A study of five years, aimed at assessing the long -term effects of semaglutide on eye diseases in people with type 2 diabetes is currently underway. It will undoubtedly make it possible to adjust the balance of risk benefits of this medication.
Note also that a map of the efficiency and risks of GLP-1 agonists have just been published in Medicine nature. The authors of this document report that the use of these drugs leads to an increased risk of gastrointestinal disorders, hypotension, syncope, arthritis disorders, kidney stones and acute pancreatitis, compared to usual care.
With an unwavering passion for local news, Christopher leads our editorial team with integrity and dedication. With over 20 years’ experience, he is the backbone of Wouldsayso, ensuring that we stay true to our mission to inform.
