在2型糖尿病中,塞马格卢提德或提尔泽帕提德和视神经和视觉通路障碍
Lindsey Wang1, Nora D Volkow2, David C Kaelber3
1Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, Ohio.
JAMA network open
|August 11, 2025
概括
新型糖尿病药物西马格卢提德和提泽帕提德与视神经疾病的更高风险有关,包括非动脉炎前部缺血性视神经病变 (NAION). 虽然整体风险较低,但建议对服用这些药物的患者进行密切监测.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 赛马格卢提德和蒂尔泽帕提德是新型的葡萄糖类-1受体激动剂,用于2型糖尿病和肥胖症.
- 以前的报道表明这些药物与非动脉炎前部缺血性视神经病变 (NAION) 之间存在联系,但研究结果不一致.
- 与其他视神经疾病的关联仍然不清楚.
研究的目的:
- 调查半黄或提泽帕提德治疗与视神经和视觉通路障碍的新诊断之间的关联.
- 为了比较2型糖尿病患者中这些疾病的风险,他们接受了semaglutide/tirzepatide治疗,而不是其他抗糖尿病药物.
主要方法:
- 一项使用美国电子健康记录的队列研究 (2017年12月-2023年1月).
- 倾向性得分匹配被用来比较服用西马格卢提德/蒂尔泽帕提德的患者与服用其他抗糖尿病药物的患者.
- 结果包括在2年的随访期间首次诊断出NAION和其他视神经疾病.
主要成果:
- 在159,398名匹配患者中,与对照组相比,塞马格卢提德/蒂尔泽帕提德使用者表现出NAION (HR, 1.76) 和其他视神经疾病 (HR, 1.65) 的风险增加.
- 药物组中NAION的绝对风险为0.04%,对照组为0.02%.
- 没有发现与其他视觉通路障碍的相关性.
结论:
- 在2型糖尿病患者中,塞马格卢提德和蒂尔泽帕提德与NAION和其他视神经疾病的风险增加有关.
- 尽管总体发病率低,但这些发现强调了监测视神经疾病的重要性.
- 进一步的研究可能是有必要的,以阐明潜在的机制和长期影响.
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