Semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy

JAMA Ophthalmology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 20, 2025

Importance Semaglutide, a glucagonlike peptide-1 receptor agonist (GLP-1RA), has recently been implicated in cases of nonarteritic anterior ischemic optic neuropathy (NAION), raising safety concerns the treatment type 2 diabetes (T2D). Objective To investigate potential association between semaglutide and NAION Observational Health Data Sciences Informatics (OHDSI) network. Design, Setting, Participants This was retrospective study across 14 databases (6 administrative claims 8 electronic health records). Included were adults with T2D taking semaglutide, other GLP-1RA (dulaglutide, exenatide), or non–GLP-1RA medications (empagliflozin, sitagliptin, glipizide) from December 1, 2017, to 31, 2023. The incidence proportion rate calculated. Association assessed using approaches: an active-comparator cohort design comparing new users those GLP-1RAs drugs, self-controlled case-series (SCCS) analysis compare individuals’ risks during exposure nonexposure periods for each drug. used propensity score–adjusted Cox proportional hazards models estimate hazard ratios (HRs). SCCS conditional Poisson regression (IRRs). Network-wide HR IRR estimates generated random-effects meta-analysis model. Exposures non–GLP-1RAs. Main Outcomes Measures under alternative definitions based on diagnosis codes: one more inclusive sensitive, restrictive specific. Results included 37.1 million individuals T2D, including 810 390 users. Of 43 620 Optum’s deidentified Clinformatics Mart Database, 24 473 (56%) aged 50 69 years, 26 699 (61%) female. 14.5 per 100 000 person-years among not different compared that non–GLP-1RAs sensitive definition—empagliflozin (HR, 1.44; 95% CI, 0.78-2.68; P = .12), sitagliptin 1.30; 0.56-3.01; .27), glipizide 1.23; 0.66-2.28; .25). risk higher only patients empagliflozin 2.27; 1.16-4.46; .02) specific definition. showed increased (meta-analysis IRR, 1.32; 1.14-1.54; < .001). Conclusions Relevance this suggest modest increase associated use, smaller than previously reported, warranting further investigation into clinical implications association.

Language: Английский

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Assessment of health conditions from patient electronic health record portals vs self-reported questionnaires: an analysis of the INSPIRE study

Journal of the American Medical Informatics Association, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

Direct electronic access to multiple health record (EHR) systems through patient portals offers a novel avenue for decentralized research. Given the critical value of characterization, we sought compare computable evaluation conditions from patient-portal EHR against traditional self-report. In nationwide Innovative Support Patients with SARS-CoV-2 Infections Registry (INSPIRE) study, which linked self-reported questionnaires multiplatform data, compared across different clinical domains definitions based on diagnosis codes, medications, vital signs, and laboratory testing. We assessed their concordance using Cohen's Kappa prognostic significance differentially captured features as predictors 1-year all-cause hospitalization risk. Among 1683 participants (mean age 41 ± 15 years, 67% female, 63% non-Hispanic Whites), prevalence varied substantially between self-report (-13.2% +11.6% definitions). Compared comprehensive phenotypes, under-captured all conditions, including hypertension (27.9% vs 16.2%), diabetes (10.1% 6.2%), heart disease (8.5% 4.3%). However, codes alone were insufficient. The risk was better defined by same (area under receiver operating curve [AUROC] 0.79) than (AUROC 0.68). EHR-derived phenotypes identified higher comorbidities self-report, additionally features. solely often undercaptured suggesting role broader elements. this patient-portal-derived data enabled extensive capture characteristics platforms, allowing phenotyping

Language: Английский

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Insights into the Roles of GLP-1, DPP-4, and SGLT2 at the Crossroads of Cardiovascular, Renal, and Metabolic Pathophysiology

Cells, Journal Year: 2025, Volume and Issue: 14(5), P. 387 - 387

Published: March 6, 2025

In recent years, new drugs for the treatment of type 2 diabetes (T2D) have been proposed, including glucagon-like peptide 1 (GLP-1) agonists or sodium–glucose cotransporter (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors. Over time, some these agents (in particular, GLP-1 SGLT2 inhibitors), which were initially developed their glucose-lowering actions, demonstrated significant beneficial pleiotropic effects, thus expanding potential therapeutic applications. This review aims to discuss mechanisms, GLP-1, DPP-4, SGLT2, with a particular focus on cardiorenal benefits beyond glycemic control.

Language: Английский

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Artificial Intelligence in the Management of Heart Failure

Journal of Cardiac Failure, Journal Year: 2025, Volume and Issue: unknown

Published: May 1, 2025

Language: Английский

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Cardiovascular and renal effects of the combination therapy of a GLP-1 receptor agonist and an SGLT2 inhibitor in observational real-life studies

Diabetes & Metabolism, Journal Year: 2024, Volume and Issue: unknown, P. 101594 - 101594

Published: Nov. 1, 2024

Language: Английский

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Finding Truth in Observational and Interventional Studies in Diabetes and Cardiovascular Disease

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 84(10), P. 918 - 920

Published: Aug. 26, 2024

Language: Английский

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