GLP-1R Agonists as Glaucoma Treatment in Diabetics

Article: Diabetes Medications Linked to Glaucoma Prevention
Source: University of Pennsylvania Medicine
Published: September 20, 2021

A retrospective study examining a class of diabetes medications called glucagon-like peptide-1 receptor (GLP-1R) agonists (Trulicity and Rybelsus) shows a possible protective effect against glaucoma in patients with diabetes. GLP-1R agonists are normally used to regulate blood glucose in type 2 diabetes mellitus. However, evidence in animal models shows that this class of drugs provides some neuroprotection against Alzheimer's and Parkinson's diseases, with clinical trials underway to test the drug against neurodegenerative diseases in humans. An earlier study from 2020 similarly found that the GLP-1R agonist NLY01 reduced retinal neuroinflammation and glial activation to rescue retinal ganglion cells in a mouse model of glaucoma, spurring the researchers to investigate whether exposure to GLP-1R agonists influences glaucoma risk. The investigators looked at an insurance claims database (Clinformatics Data Mart), with cohorts comprised of 1961 new users of GLP-1R agonists matched to 4371 unexposed controls. They found that after 150 days on average, 10 patients (0.51%) in the medicated group were newly diagnosed with glaucoma compared to 58 patients (1.3%) in the control group. After adjustment, the data shows a reduced hazard ratio of 0.56, suggesting that exposure to GLP-1 receptor agonists may decrease a diabetic patient’s risk of developing glaucoma by half. The researchers remark that the encouraging findings from their study warrant further investigation into the potential of GLP-1R agonists in glaucoma prevention.

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Sterling J, Hua P, Dunaief JL, et al. "Glucagon-like peptide 1 receptor agonist use is associated with reduced risk for glaucoma." British Journal of Ophthalmology.  19 August 2021. https://doi.org/10.1136/bjophthalmol-2021-319232