Assessing the risk of diabetic retinopathy progression with GLP-1 receptor agonists: a systematic review and meta-analysis
Abstract
Background: Diabetic retinopathy (DR) is a significant cause of vision impairment in patients with diabetes. The impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on the progression of DR remains unclear. This systematic review and meta-analysis aimed to evaluate the association between GLP-1RA therapy and DR progression.
Methods: A comprehensive search of electronic databases identified 161 records, of which 11 studies met the inclusion criteria. Included studies comprised randomized controlled trials (RCTs) and retrospective cohort studies conducted in North America, Europe, and East Asia, with sample sizes ranging from 137 to 9,463 participants. The primary GLP-1RAs analyzed were albiglutide, liraglutide, semaglutide, exenatide, and dulaglutide, compared to either placebo or SGLT-2 inhibitors. The primary outcome was DR progression, assessed through pooled relative risk (RR) estimates using a random-effects model. Subgroup analyses were conducted by GLP-1RA type and geographical location. Sensitivity analyses and assessment of publication bias (via funnel plot, Egger's test, and Begg's test) were performed. Risk of bias was evaluated using the Cochrane tool.
Results: The meta-analysis indicated no statistically significant association between GLP-1RA use and DR progression (pooled RR = 1.07, 95% confidence interval [CI]: 0.90-1.28). Subgroup analyses by GLP-1RA type and geographical location also showed no significant differences. However, semaglutide…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 9,463 participants or records.
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