{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:46:28Z","timestamp":1790628388428,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Non\u2010arteritic anterior ischemic optic neuropathy (NAION) has emerged as a safety concern with semaglutide, prompting formal regulatory review and action by the European Medicines Agency. However, its occurrence across the broader class of incretin\u2010based therapies is insufficiently characterised. This study used the FDA Adverse Event Reporting System to evaluate and compare pharmacovigilance signals for optic ischaemic neuropathy across six incretin\u2010based therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Adverse event reports from each drug's approval date through Q3 2025 were extracted using OpenVigil 2.1. The Medical Dictionary for Regulatory Activities term \u201coptic ischaemic neuropathy\u201d was used as the outcome. Disproportionality analysis was performed using reporting odds ratio (ROR) and proportional reporting ratio (PRR) with 95% confidence intervals, applying Evans' criteria, restricted to primary suspect drug reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Semaglutide demonstrated a strong post\u2010marketing safety signal for optic ischaemic neuropathy (355 reports; ROR 94.45, 95% CI: 83.02\u2013107.45; PRR 93.77, 95% CI: 82.48\u2013106.61). Tirzepatide and liraglutide also exhibited significant safety signals (49 reports; ROR 2.94, 95% CI: 2.20\u20133.93; PRR 2.94, 95% CI: 2.20\u20133.93; and 13 reports; ROR 4.58, 95% CI: 2.65\u20137.91; PRR 4.58, 95% CI: 2.65\u20137.91, respectively). No signal was identified for dulaglutide, exenatide, or lixisenatide. Among semaglutide\u2010associated reports, mean age was 59\u2009years; disability was documented in 18% and hospitalization in 11% of cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant post\u2010marketing safety signals for optic ischaemic neuropathy were identified for semaglutide, tirzepatide, and liraglutide. The absence of signals with other glucagon\u2010like peptide\u20101 receptor agonists argues against a uniform class effect. Prospective studies with neuro\u2010ophthalmologist\u2010confirmed diagnoses are warranted to establish causality and quantify absolute risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70952","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T01:13:15Z","timestamp":1780967595000},"page":"7527-7535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optic Ischaemic Neuropathy in Incretin\u2010Based Therapy: A Comparative Analysis of Real\u2010World Safety Data"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7768-7304","authenticated-orcid":false,"given":"Ashish Kumar","family":"Kakkar","sequence":"first","affiliation":[{"name":"Department of Pharmacology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuvasree","family":"Payra","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarzoo","family":"Charaya","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2206038"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107519"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2032183"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607141"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12886\u2010025\u201004559\u2010x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20\u20101815"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22\u20102521"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2014.144"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2007.05.027"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/vision7040072"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2024.2296"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2024.10.030"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2024.6555"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2025.02.025"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16316"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.70200"},{"key":"e_1_2_8_18_1","unstructured":"\u201cThe Use of Semaglutide Medicines and Risk of Non\u2010Arteritic Anterior Ischemic Optic Neuropathy (NAION) \u201d World Health Organization. accessed June 5 2026 https:\/\/www.who.int\/news\/item\/27\u201006\u20102025\u201027\u201006\u20102025\u2010semaglutide\u2010medicines\u2010naion."},{"key":"e_1_2_8_19_1","unstructured":"European Medicines Agency \u201cPRAC Concludes Eye Condition NAION is a Very Rare Side Effect of Semaglutide Medicines Ozempic Rybelsus and Wegovy \u201dEuropean Medicines Agency (EMA). June 6 2025 accessed March 29 2026 https:\/\/www.ema.europa.eu\/en\/news\/prac\u2010concludes\u2010eye\u2010condition\u2010naion\u2010very\u2010rare\u2010side\u2010effect\u2010semaglutide\u2010medicines\u2010ozempic\u2010rybelsus\u2010wegovy."},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.70160"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fdsfr.2023.1323057"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.677"},{"key":"e_1_2_8_23_1","unstructured":"R.B\u00f6hmandH. 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