A new risk? Macular Degeneration

Here at GLP1.Guide we like to keep an eye out for negative side effects as most of the world is focused on how beneficial GLP1s can be.

A new risk has been flagged in a paper that we found interesting: Macular Degeneration:

Published in Jama, the study notes that there was an increase (doubling) in macular degeneration for participants who took GLP1s.

This isn't the first time GLP1s have been linked to issues with eyes

Semaglutide was linked to blinding disease NAION in the past:

Semaglutide’s link to blinding disease (NAION)

We explore the link between blinding disease/vision loss and Semaglutide, as reported by medical research.

GLP1 GuideGLP1.Guide Staff

At that time, the American Academy of Opthamology came to a simple conclusion: they did not recommend stopping a prescription of Semaglutide because of this, except in the case of vision loss.

The simple fact that although vision changes did occur with Semaglutide, it could not be conclusively proven to be a direct cause of NAION, especially since one of the intended effects of GLP1s are changes in blood sugar which can cause blurred vision.

Consider reading the new study yourself

While we summarize and provide some analysis on studies, we often advocate reading sources for yourself, and if you'd like to do so, you can read here:

Glucagon-Like Peptide-1 Receptor Agonists and Risk of Neovascular Age-Related Macular Degeneration - PubMed

In this cohort study, the use of GLP-1 RAs among patients with diabetes was associated with a 2-fold higher risk of incident nAMD development than among similar patients with diabetes who did not receive a GLP-1 RA. Further research is needed to elucidate the exact pathophysiological mechanisms invo …

PubMedReut Shor

Importantly, the section worth reading are the results:

Results: Among 139 002 matched patients, mean (SD) patient age was 66.2 (7.5) years, and 64 775 patients (46.6%) were women. The incidence of nAMD was higher among the exposed cohort than among the unexposed cohort. Cox proportional hazard models, both unadjusted (crude) and adjusted, estimated hazard ratios for nAMD development of greater than 2.0 among patients exposed to GLP-1 RAs (exposed, 0.2% vs unexposed, 0.1%; difference, 0.1%; crude: HR, 2.11; 95% CI, 1.58-2.82; adjusted: HR, 2.21; 95% CI, 1.65-2.96).

While it's a bit hard to parse within the prose, the risk of macular degeneration (nAMD) went from 0.1% to 0.2% in the cohorts that were studied.

Our Analysis: Is this new risk worth watching for?

There are a few things that are probably worth noting about this paper:

• It's a study, not a trial – patient data was analyzed rather than obtained "live"
• While risk doubled, it moved from 0.1% to 0.2%
• Analyzed patients were over 65 years old and had diabetes

For many people who are considering taking GLP1s to prevent onset of Type 2 diabetes, or manage their weight, it's likely that the above risk factors are inconsequential in comparison to heart disease and other risks.

Said differently, the risks from not managing type 2 diabetes or weight are likely far greater than an increase from 0.1% to 0.2% of macular degeneration (which is likely to occur in old age from the start).

This study actually suggests the opposite: GLP1s are incredibly safe

While this study should certainly not be completely ignored, the results from this study actually have done a lot to suggest the opposite of the flashy headline – GLP1s are incredibly safe.

Doing this analysis on over 139,000 patients and only finding an incidence of increased macular degeneration might be quite surprising to many that expected many more negative side effects.

Of course, speaking to a medical professional is the best way to find the appropriate advice before starting medication. It's unreasonable for any website on the internet to suggest anything different – but as a matter of opinion (rather than fact), the risk profile GLP1s are likely not hugely changed by this new discovery.