| アブストラクト | OBJECTIVE: To estimate the effect of initiating glucagon-like peptide 1 receptor agonists (GLP-1 RAs) versus dipeptidyl peptidase 4 (DPP-4) inhibitors on incident nonarteritic anterior ischemic optic neuropathy (NAION) among adults with type 2 diabetes. RESEARCH DESIGN AND METHODS: This active-comparator, new-user cohort emulated a pragmatic target trial using the U.K. Clinical Practice Research Datalink. Patients aged >/=18 years with a physician diagnosis of type 2 diabetes who newly initiated a GLP-1 RA or a DPP-4 inhibitor were included. DPP-4 inhibitors were selected as the comparator because they may be used as second-line treatment, like GLP-1 RAs, and have no established association with NAION. We estimated risks, risk differences (RDs), and risk ratios (RRs) of incident NAION, adjusted using propensity-score fine-stratification weighting. RESULTS: At 1 year, there were 14 NAION events among 106,858 GLP-1 RA initiators (18.5 per 100,000) and 53 among 416,369 DPP-4 inhibitor initiators (7.2 per 100,000). GLP-1 RAs were associated with an increased risk of NAION compared with DPP-4 inhibitors (RR 2.56; 95% CI 1.44-4.86; RD 11.3 per 100,000). The risk of NAION was higher during the first 6 months of use, diminishing with longer duration of use, and was higher in patients aged <50 years, men, ever-smokers, and those with >/=1% hemoglobin A1c reduction. CONCLUSIONS: GLP-1 RAs were associated with an increased 1-year risk of NAION compared with DPP-4 inhibitors among adults with type 2 diabetes, particularly in younger patients, men, ever-smokers, and patients with a marked hemoglobin A1c reduction. |
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| ジャーナル名 | Diabetes care |
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| Pubmed追加日 | 2026/2/17 |
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| 投稿者 | Noh, Yunha; Yin, Hui; Ben Ghezala, Ines; Yu, Oriana H Y; Suissa, Samy; Azoulay, Laurent |
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| 組織名 | College of Pharmacy, Chonnam National University, Gwangju, South Korea.;Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital,;Montreal, Canada.;Department of Epidemiology, Biostatistics and Occupational Health, McGill;University, Montreal, Canada.;Department of Ophthalmology, Dijon University Hospital, Dijon, France.;Clinical Investigation Center 1432, Clinical Epidemiology/Clinical Trials Unit,;INSERM, Dijon University Hospital, Dijon, France.;Division of Endocrinology, Jewish General Hospital, Montreal, Canada.;Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41701611/ |
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