By Nancy Lapid
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A large study adds to evidence that the main ingredient in Novo Nordisk’s injectable GLP-1 drug for type 2 diabetes may increase patients’ risk for a dangerous eye condition, researchers reported on Thursday in JAMA Ophthalmology.
The researchers tracked nearly 175,000 patients with diabetes who received semaglutide — the active ingredient in Ozempic and other Novo products — and the same number of patients with diabetes who received non–GLP-1 drugs.
The higher risk of developing the sight-threatening eye problem known as nonarteritic anterior ischemic optic neuropathy, or NAION, did not appear during patients’ first year of treatment with semaglutide. But their risk for NAION was more than doubled after two years of treatment, compared to patients taking diabetes medicines from other classes.
In subgroup analyses, the elevated risk for NAION associated with semaglutide was confined to women and to patients taking Ozempic, which is only one of Novo’s semaglutide products.
Patients with diabetes who received Rybelsus, an oral semaglutide, or Wegovy, which is injected like Ozempic and approved for obesity, had no increased risk for NAION compared with those who received non–GLP-1 medications.
A small study published last year and a separate large study published last month had similarly found that adults with type 2 diabetes using semaglutide had a higher NAION incidence rate than when they were not using the medication.
The authors of the new report note that retrospective studies such as these cannot prove causation.
“Because NAION is a potentially debilitating ophthalmic condition, gaining a clearer understanding of its incidence and the factors influencing its occurrence would enhance care for those considering the use of these medications,” they said.
NON-INVASIVE TEST AS GOOD FOR WOMEN WITH URINARY INCONTINENCE
Women with urinary incontinence could avoid invasive bladder pressure tests because non-invasive assessments work just as well, a new study shows.
A separate study by a different team describes another way to improve women’s care: a female-specific urinal bottle that can reduce the use of urinary catheters for immobile women.
At the European Association of Urology Congress in Madrid, researchers reported on a trial comparing invasive urodynamics testing to a physical exam and questionnaire in women with overactive bladder or urinary incontinence for whom initial treatments such as pelvic floor exercises and bladder retraining weren’t helpful.
Invasive urodynamics tests involve filling the bladder with water through a catheter inserted into the bladder and then inserting another catheter into the vagina or rectum to measure pressures in the bladder and abdomen.
The researchers had 1,099 women with overactive bladder or urinary incontinence from across the UK fill out a detailed medical questionnaire, undergo a thorough physical examination, keep a bladder diary, and perform a “cough test” to assess for stress incontinence.
Half of the women also underwent the uncomfortable invasive testing.
While women who underwent invasive testing received more tailored treatments based on the test result, there was no significant difference between the effects of the two forms of assessment on patients’ outcomes over the next two years, according to a report in The Lancet.
About 24% of women said their symptoms were ‘very much’ and ‘much’ improved in the urodynamics group versus about 23% in the non-invasive assessment group.
Invasive urodynamics tests can be embarrassing and uncomfortable, study leader Mohamed Abdel-Fattah of the University of Aberdeen said in a statement.
“For many women who are struggling with finding a treatment that works for this type of urinary incontinence, our trial shows they no longer have to go through that experience to achieve an improvement in their symptoms and quality of life,” he said.
Separately, in the Emergency Medical Journal, UK researchers describe how an immobilized female patient inspired them to create a disposable urinal for women.
They modified disposable male urinal bottles to accommodate the female perineum without need to reposition the patient. Then they formalized the design of the urinal and tested it in other hospitals and an ambulance service.
In one trial involving 103 immobile female patients and 118 healthcare professionals, 74% of patients and 78% of healthcare professionals said they would recommend the urinal.
“Patients felt they avoided pain because the urinal minimized movement and that it was a more dignified way to void their bladder,” the researchers wrote. “Healthcare professionals felt that the potential advantages were reducing the need for urinary catheters, and reducing lifting and log rolling patients.”
(Reporting by Nancy Lapid; editing by Bill Berkrot)
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