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Semaglutide and Diabetic Retinopathy Risk in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials

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Abstract

Background

Semaglutide is a recently approved glucagon-like peptide-1 receptor agonist used to treat patients with type 2 diabetes mellitus (T2DM). The SUSTAIN 6 trial found a significantly higher rate of retinopathy complications in the semaglutide-treated group compared with the placebo group.

Objective

This study aimed to evaluate the association between semaglutide and the risk of retinopathy in patients with T2DM.

Methods

Electronic databases were systematically searched up to April 2021 to identify randomized controlled trials that reported diabetic retinopathy (DR) events in semaglutide-treated and control groups. A meta-analysis was conducted using Review Manager 5.4 software to calculate the risk ratio (RR) and 95% confidence intervals (CIs).

Results

A total of 23 randomized trials involving 22,096 patients with T2DM were included. There were 730 incident DR cases—463 in the semaglutide group and 267 in the control group. Overall, semaglutide was not associated with increased DR risk compared with controls when all trials were combined (RR 1.14, 95% CI 0.98–1.33). Subgroup analysis showed that semaglutide was associated with an increased risk of DR compared with placebo (RR 1.24, 95% CI 1.03–1.50). Moreover, patient age ≥ 60 years and diabetes duration ≥ 10 years were also factors for increased risk of DR when using semaglutide (RR 1.27, 95% CI 1.02–1.59; RR 1.28, 95% CI 1.04–1.58, respectively).

Conclusions

Semaglutide was not associated with an increased risk of DR; however, caution regarding DR risk is needed for older patients or those with long diabetes duration when taking semaglutide.

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Authors and Affiliations

  1. Department of Pharmacy, The First Affiliated Hospital, Fujian Medical University, Chazhong Road No. 20, Fuzhou, 350005, China

    Feiyu Wang, Yinjun Mao, Hang Wang, Yiwei Liu & Pinfang Huang

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Correspondence to Pinfang Huang.

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Funding

This work was supported by the Startup Fund for Scientific Research, Fujian Medical University (Grant number 2018QH1071) and the Fujian Youth Education Research Project (Grant number JT180186).

Conflict of interest

Feiyu Wang, Yinjun Mao, Hang Wang, Yiwei Liu, and Pinfang Huang disclose that they have no conflicts of interest.

Ethics approval

Because this was a secondary literature-based study, ethic approval is not necessary.

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Data sharing is not applicable to this article as no new data were created or analyzed in this study.

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Author contributions

FYW was involved in the design of the study, extraction of the data, statistical analyses, interpretation of the results, and drafting and revising the manuscript. YJM was involved in the design of the study, extraction of the data, and revising the manuscript. HW was involved in the interpretation of the results, and drafting and revising the manuscript. YWL was involved in revising the manuscript. PFH is the guarantor of the manuscript. She attests that all listed authors meet the authorship criteria and that no others meeting the criteria have been omitted.

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Wang, F., Mao, Y., Wang, H. et al. Semaglutide and Diabetic Retinopathy Risk in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials. Clin Drug Investig 42, 17–28 (2022). https://doi.org/10.1007/s40261-021-01110-w

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