Risk of nonarteritic anterior ischemic optic neuropathy (NAION) in patients prescribed semaglutide – Novo Nordisk

A new observational study reported for the first time a potential link between Novo Nordisk’s GLP-1 drugs Ozempic and Wegovy and an eye condition that can cause vision loss.

After hearing anecdotes of patients on the diabetes and obesity drugs experiencing nonarteritic anterior ischemic optic neuropathy, or NAION, researchers at Massachusetts Eye and Ear analyzed data from a registry of patients at their institution to see if there was a broad trend. Among 710 patients with type 2 diabetes, there were 17 cases of NAION in patients prescribed semaglutide (the scientific name of both Ozempic and Wegovy). This translated to a cumulative rate of 8.9% over three years. That compares with six cases in patients prescribed non-GLP-1 diabetes drugs, calculated as a cumulative rate of 1.8%. Through statistical analyses, the researchers estimate that there was a 4.28 times greater risk of developing the condition in patients prescribed semaglutide, according to the study, published in JAMA Ophthalmology.

Studying 979 patients who had overweight or obesity, researchers found 20 cases of NAION in people prescribed semaglutide, calculated as a cumulative rate of 6.7%. In comparison, there were three cases in people prescribed non-GLP-1 obesity drugs, calculated as a cumulative rate of 0.8%. The researchers estimate that there was a 7.64 times greater risk of developing the condition in patients prescribed semaglutide.

In both the diabetes and obesity cohorts that got semaglutide, the researchers found that NAION cases occurred most frequently in the first year after the medications were prescribed.

NAION, sometimes referred to as an “eye stroke,” occurs from a lack of sufficient blood flow to the optic nerve. It typically causes sudden vision loss and, in severe cases, can lead to blindness. There are currently no proven treatments for the condition.

NAION was not reported as an adverse event in trials studying semaglutide. As drugs go on the market and many more people take them, it’s common for doctors to find new rare side effects that weren’t seen in the controlled studies. The authors stress, though, that this observational study does not show that the drugs cause higher rates of NAION — just that there is a potential association.

The study also focused only on semaglutide, and the findings cannot be immediately generalized to other GLP-1 drugs. The researchers still believed it’s important to report the findings to spur further analysis and to make doctors and patients aware.

See-July 3, 2024
“Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide”-
Jimena Tatiana Hathaway, MD, MPH; Madhura P. Shah, BS; David B. Hathaway, MD; et al., JAMA Ophthalmol. Published online July 3, 2024. doi:10.1001/jamaophthalmol.2024.2296.