Semaglutide and diabetic retinopathy: an OHDSI network study

作者：Cindy Xinji Cai, Akihiko Nishimura, Sally L. Baxter, Kerry Goetz, Michelle R. Hribar, Brian C. Toy, Andrew J. Barkmeier, Sophia Ying Wang, Swarup S. Swaminathan, Alexis M. Flowers, Eric N. Brown, Benjamin Yixing Xu, John Jing-Wei Chen, Aiyin Chen, Theodore Leng, Michael Vincent Boland, Thamir Alshammari, Fan Bu, Thomas Falconer, Benjamin R. Martin, Erik Westlund, Nestoras Nicolas Mathioudakis, Linying Zhang, Ruochong Fan, Adam B Wilcox, Albert M. Lai, Jacqueline C. Stocking, Yangyiran Xie, Lok Hin Lee, David A Dorr, Izabelle Humes, David B. McCoy, Mohammad Adibuzzaman, Raymond G. Areaux, James T. Brash, Nicole G. Weiskopf, Hannah Morgan‐Cooper, Priya K. Desai, Diep D. Tran, Zainab Rustam, Gu Zhu, Joel N. Swerdel, Anthony G. Sena, Paul G. Nagy, Marc A. Suchard, Martijn J. Schuemie, George M. Hripcsak, Patrick B. Ryan · 发表于：BMJ Open Diabetes Research & Care · 年份：2025 · DOI：10.1136/bmjdrc-2025-005424 · 被引用次数：5 · 研究领域：Diabetes Treatment and Management、Retinal Diseases and Treatments、Diabetes, Cardiovascular Risks, and Lipoproteins

INTRODUCTION: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA) used to treat type 2 diabetes mellitus (T2D), has potential associations with higher rates of diabetic retinopathy (DR) complications including proliferative DR (PDR) and diabetic macular edema (DME). The purpose of this study was to determine whether an association exists between semaglutide and PDR and treatment-requiring DR/DME. RESEARCH DESIGN AND METHODS: This was a retrospective cohort study of 14 databases (six administrative claims and eight electronic health records) in the Observational Health Data Sciences and Informatics Evidence Network. Adults with T2D on semaglutide, other GLP-1RA (dulaglutide, exenatide), or non-GLP-1RA medications (empagliflozin, sitagliptin, glipizide) from 1 December 2017 to 31 December 2023 were included. The association between semaglutide and PDR or treatment-requiring DR/DME was assessed using an active-comparator cohort design comparing new users of semaglutide as second-line T2D treatment to those on other GLP-1RAs and non-GLP-1RAs. Propensity score-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs). Network-wide HR estimates were generated using a random-effects meta-analysis. RESULTS: The study included 810 390 new semaglutide users for T2D. PDR risk for semaglutide was similar to dulaglutide (HR 0.81, 95% CI 0.42 to 1.54, p=0.51), empagliflozin (HR 0.83, 95% CI 0.53 to 1.30, p=0.41) and sitagliptin (HR 0.83, 95% CI 0.45 t...