Philadelphia—A widely used class of diabetes medications can help protect patients against developing glaucoma.

Those findings, published in the British Journal of Ophthalmology, were based on retrospective data involving 1,961 patients with diabetes who were new users of glucagon-like peptide-1 receptor (GLP-1R) agonists compared with 4,371 controls who initiated diabetes medications from different classes.  

The University of Pennsylvania’s Perelman School of Medicine researchers point out that, after 150 days on average, 10 patients in the medicated group were newly diagnosed with glaucoma (0.5%) compared with 58 patients (1.3%) in the control group. That signals that GLP-1 receptor agonists might decrease the risk of developing glaucoma by half in patients with diabetes.

A previous Penn Medicine study from 2020 found that GLP-1R agonists reduced neuroinflammation and prevented retinal ganglion cell death in mice. Glaucoma, which affects 3 million Americans and is the second leading cause of blindness worldwide, is twice as likely to occur in diabetes patients as others.

“It was very encouraging to see that a popular diabetes medication could significantly reduce the risk of developing glaucoma, and our study suggests that these medications warrant further study in this patient population,” said Qi N. Cui, MD, PhD, with Brian VanderBeek, MD, MPH, both assistant professors of ophthalmology at Penn.

Another recent article describes how findings like the one in the Penn study have altered considerations for use of GLP-1RA therapy in type 2 diabetes patients.

“Since the first glucagon-like peptide 1 (GLP-1) receptor agonist (GLP-1RA) was approved in 2005 (exenatide twice daily) for type 2 diabetes (T2D), the class has developed with newer compounds having more pronounced effects on glycemic control and body weight,” according to Danish authors writing in Diabetes, Obesity & Metabolism. “Also, administration regimes have become more convenient with once-weekly injections, and recently an oral-administration product has become available."

Part of what changed is that large-scale randomized, controlled cardiovascular outcome trials have demonstrated that GLP-1RA therapy can reduce the risk of heart disease in high-risk individuals with T2D. There is also increasing evidence that GLP-1RAs might have renal benefits related to new-onset macroalbuminuria.

“Subsequently, the place for GLP-1RA therapy has changed over recent years, with most societies endorsing GLP-1RA therapy in patients with established or high risk of CVD independently of glycemia,” the authors concluded.

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