Glucagon-like peptide 1 receptor agonist use is associated with reduced risk for glaucoma

Background/aimsGlucagon-like peptide-1 receptor (GLP-1R) agonists regulate blood glucose and are commonly used to treat type 2 diabetes mellitus. Recent work showed that treatment with the GLP-1R agonist NLY01 decreased retinal neuroinflammation and glial activation to rescue retinal ganglion cells in a mouse model of glaucoma. In this study, we used an insurance claims database (Clinformatics Data Mart) to examine whether GLP-1R agonist exposure impacts glaucoma risk.MethodsA retrospective cohort of patients who initiated a new GLP-1R agonist was 1:3 age, gender, race, classes of active diabetes medications and year of index date matched to patients who initiated a different class of oral diabetic medication. Inverse probability of treatment weighting (IPTW) was used within a multivariable Cox proportional hazard regression model to test the association between GLP-1R agonist exposure and a new diagnosis of primary open-angle glaucoma, glaucoma suspect or low-tension glaucoma.ResultsCohorts were comprised of 1961 new users of GLP-1R agonists matched to 4371 unexposed controls. After IPTW, all variables were balanced (standard mean deviation <|0.1|) between cohorts. Ten (0.51%) new diagnoses of glaucoma were present in the GLP-1R agonist cohort compared with 58 (1.33%) in the unexposed controls. After adjustment, GLP-1R exposure conferred a reduced hazard of 0.56 (95% CI: 0.36 to 0.89, p=0.01), suggesting that GLP-1R agonists decrease the risk for glaucoma.ConclusionsGLP-1R agonist use was associated with a statistically significant hazard reduction for a new diagnosis of glaucoma. Our findings support further investigations into the use of GLP-1R agonists in glaucoma prevention.

GLAUCOMA DE PRESSÃO NORMAL: UMA REVISÃO INTEGRATIVA E SEUS TRATAMENTOS

INTRODUÇÃO: O glaucoma de pressão normal (GPN) é uma neuropatia óptica progressiva que possui a pressão intraocular (PIO) dentro da faixa de normalidade (≤ 21 mmHg). Na prática clínica, a base do tratamento do GPN é a redução da PIO, entretanto, aproximadamente 50% dos pacientes ainda apresentam perda de campo visual apesar de baixos valores da PIO. METODOLOGIA: Pesquisa de coletas de dados de artigos e ensaios clínicos randomizados na plataforma PubMed, utilizando os descritores: “Glaucoma” e “Low Tension Glaucoma”. RESULTADOS: Houve eficácia de medidas terapêuticas farmacológicas ou não sobre a redução da PIO (18 estudos). Todos que abordaram a cirurgia concordam que esta reduz a PIO. Sobre terapia farmacológica, todos confirmam que os fármacos estudados reduzem a PIO. CONCLUSÃO: As medidas farmacológicas, quanto as cirurgias anti-glaucomatosas são eficazes em reduzir a PIO.