GLP-1 RAs lower POAG, ocular hypertension risks in T2D patients

The use of glucagon-like peptide 1 receptor agonists (GLP-1 RA), compared with metformin, results in a significant decrease in the incidence of primary open-angle glaucoma (POAG), ocular hypertension, and the need for first-line glaucoma treatments in patients with type 2 diabetes (T2D), reports a study.

This retrospective cohort study obtained data from an international electronic health record network from May 2006 to 2024. Patients with a T2D diagnosis who received treatment with either GLP-1 RAs or metformin were identified.

Researchers analysed data from 120 healthcare organizations across 17 countries and assessed patient outcomes at 1, 2, and 3 years. They used propensity score matching (PSM) to balance covariates such as demographics, comorbidities, and medication use.

Both treatment groups included 61,998 patients at 1-year follow-up, 27,414 at 2-year follow-up, and 14,100 at 3-year follow-up after PSM.

Patients in the GLP-1 RA group had a significantly lower risk of POAG development than those in the metformin group at 1 year (risk ratio [RR], 0.59, 95 percent confidence interval [CI], 0.39‒0.88), 2 years (RR, 0.50, 95 percent CI, 0.32‒0.78), and 3 years (RR, 0.59, 95 percent CI, 0.37‒0.94).

Similarly, GLP-1 RAs provided protection against ocular hypertension at 1 year (RR, 0.44, 95 percent CI, 0.31‒0.62), 2 years (RR, 0.43, 95 percent CI, 0.30‒0.62), and 3 years (RR, 0.51, 95 percent CI, 0.34‒0.75).

In addition, patients treated with GLP-1 RAs had a lower risk of first-line therapy initiation at 1 year (RR, 0.63, 95 percent CI, 0.53‒0.74), 2 years (RR, 0.71, 95 percent CI, 0.59‒0.85), and 3 years (RR, 0.75, 95 percent CI, 0.62‒0.91).

“These findings highlight the potential ocular benefits of GLP-1 receptor agonists and their expanding role in the clinical management of patients with diabetes,” the researchers said.