{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:02:41Z","timestamp":1791576161843,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK138036"],"award-info":[{"award-number":["R01DK138036"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Evidence on the safety of semaglutide and other glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RA) concerning non\u2010arteritic anterior ischemic optic neuropathy (NAION) is inconclusive, with several studies published to date presenting methodological challenges. We sought to compare the risk of presumed NAION in patients with type 2 diabetes (T2D), initiating a GLP\u20101RA versus a sodium\u2010glucose cotransporter\u20102 inhibitor (SGLT2i), using a new\u2010user active comparator cohort study design within a target trial emulation framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Using insurance claims data from three databases (01\/2016\u201308\/2024), we identified 482\u2009912 propensity score matched (1:1) pairs of GLP\u20101RA and SGLT2i adult initiators with T2D and without prior ischemic optic neuropathy (ION) or other optic nerve disorders. NAION was defined as a diagnosis of ION without other causes of optic neuropathy, combined with an ophthalmologist or optometrist visit on the same day. We estimated pooled hazard ratios (HRs) and rate differences (RDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow\u2010up of 6.7\u2009months on treatment, the risk of incident NAION was higher among initiators of GLP\u20101RA compared with SGLT2i [HR, 1.85; 95% CI (1.51\u20132.27); RD, 0.29 (0.19, 0.39) per 1000 person\u2010years]. Results were consistent across subgroups and sensitivity analyses. A meta\u2010analysis of our semaglutide analysis with previously published results also showed an elevated risk, with a HR of 2.78 (1.39\u20135.56).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large observational study, the initiation of GLP\u20101RA was associated with an 85% increase in the risk of presumed NAION, compared with the initiation of SGLT2is, though incidence rates and absolute increase in risk were small.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70200","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T09:26:13Z","timestamp":1760693173000},"page":"1517-1528","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["<scp>GLP<\/scp>\n                    \u2010\n                    <scp>1RA<\/scp>\n                    and the risk of non\u2010arteritic anterior ischaemic optic neuropathy in patients with type 2 diabetes: A population\u2010based study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6264-2813","authenticated-orcid":false,"given":"Helen","family":"Tesfaye","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Paik","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts USA"},{"name":"New England Geriatric Research Education and Clinical Center VA Boston Healthcare System  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Wexler","sequence":"additional","affiliation":[{"name":"MGH Diabetes Center, Division of Endocrinology, Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimena Tatiana","family":"Hathaway","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Massachusetts Eye and Ear, Harvard Medical School  Boston Massachusetts USA"},{"name":"Neuro\u2010Ophthalmology Service Massachusetts Eye and Ear, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine W.","family":"Yu","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Department of Medicine Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts 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