🩺 Summary
A new analysis of FDA reports revealed a possible link between Wegovy, a weight-loss medication, and an increased risk of a rare eye condition known as ischemic optic neuropathy (ION), which may lead to sudden vision loss. Studies indicated that this risk is higher compared with other drugs based on semaglutide such as Ozempic. It also turned out that men are especially exposed to this risk at a higher rate than women. With the expanding use of GLP-1 drugs to treat obesity and diabetes, these findings create an urgent need for follow-up studies to assess safety more precisely.
🧪 What Is Wegovy and What Are the Risks of ION?
Wegovy is used as an injectable medication that promotes weight loss, and it is classified among GLP-1 drugs, which also include Ozempic (approved for diabetes treatment) and the oral drug Rybelsus.
The problem is that Wegovy may be associated with a higher risk of developing a rare condition known as ischemic optic neuropathy (ION), a disorder that occurs as a result of blockage or reduced blood flow to the optic nerve. This decrease in perfusion can lead to sudden partial or complete vision loss in one or both eyes.
🧠 Findings From the U.S. Food and Drug Administration (FDA) Safety Report Analysis
A team of researchers analyzed more than 30.6 million adverse event reports for different medications, recorded in the FDA Adverse Event Reporting System (FAERS) between December 2017 and December 2024. Among them, about 31,774 reports related to medications based on semaglutide were reviewed.
The average age of patients in the reports was 56 years, and 54% of them were women.
The analysis focused on several GLP-1 drugs, including:
- Injectable drugs such as Ozempic and Wegovy.
- The oral drug Rybelsus.
- Other drugs such as Mounjaro and Zepbound.
📊 Wegovy Shows the Strongest Association With ION
Although Ozempic recorded a larger number of reports due to earlier approval, Wegovy showed a stronger association with the risk of ION. There were 28 ION cases linked to Wegovy compared with 47 with Ozempic.
However, when the risk was measured by the “odds ratio,” or odds ratio, it was found that Wegovy carried a risk probability up to 75 times higher than expected, compared with about 19 times for Ozempic and 21 times for generic semaglutide products.
As for Rybelsus, the oral medication, no ION cases were recorded for it in this analysis.
There are differences between the sexes; male Wegovy users recorded the highest risk indicator, with an increase of up to 116 times compared with expectations, while women recorded the highest indicator with Ozempic.
The odds suggest that the risk of ION in men may be more than three times that in women.
🌱 Researchers’ Explanation for the Difference in Risk Between Wegovy and Other GLP-1 Drugs
The researchers believe that several factors may contribute to the strength of the link between Wegovy and the risk of ION, including:
- Route of administration: injectable medications are absorbed faster than oral tablets.
- Dosage: Wegovy is given in higher doses than Ozempic.
- Physiological effects: Wegovy may cause drops in blood pressure, fluid loss, and effects on the stability of the autonomic nervous system (autonomic nervous system). These factors may weaken blood perfusion to the optic nerve.
Even so, a direct causal relationship between Wegovy and ION cases has not been proven. The researchers noted that the intense media attention surrounding Wegovy may lead to increased reporting of side effects, which could affect the results of the reports.
Why Did Rybelsus Show No Risk of This Type?
The explanation for the absence of ION signals with Rybelsus is its limited absorption and the slow regularity of drug delivery into the blood, which reduces its acute effect on the body and keeps side effects within a lower range.
🧬 The Need for More Studies and Follow-Up
The researchers acknowledge that the FDA reporting system does not provide complete and accurate data on the frequency of this condition or comprehensive details about patients’ circumstances such as the severity of accompanying illnesses.
Despite this, the findings indicate a possible relationship, dependent on the type of medication and its dose, with the occurrence of ION, with a stronger signal in the case of Wegovy.
The researchers recommend conducting future prospective studies to measure risk better and analyze influencing factors, with the aim of providing clear guidance for professionals in the medical field and for regulation and oversight.
The Call for Close Medical Monitoring
Commentators on the study noted that these findings highlight the importance of monitoring patients taking anti-obesity medications and considering ocular risks by eye specialists and other experts.
🧪 Emerging Challenges as the Use of GLP-1 Drugs Increases
The researchers focus on the rising obesity rates in countries such as the United Kingdom, where 29% of adults are considered obese and 64% are either overweight or obese.
As the therapeutic uses of GLP-1 drugs expand beyond weight loss and diabetes treatment, including reducing risks associated with heart disease, stroke, and dementia, prescribing indicators for these drugs are expected to continue rising.
At the same time, concerns are being raised that increased use of these drugs, especially in children over 12 years old, may lead to rare eye complications in the future.
🧠 Potential Benefits Against Some Eye Diseases and Safety Questions
Alongside the rare risks, research indicates that GLP-1 drugs may help in other eye conditions such as age-related macular degeneration and uveitis, adding a layer of complexity to assessing the effects of this class of drugs.
However, the researchers emphasize the importance of balancing the possible benefits against the risk of serious and sudden complications such as ischemic optic neuropathy.
🩺 Conclusion
A recent analytical study raised important questions about the drug safety of Wegovy. Although ischemic optic neuropathy is rare, the evidence suggests that there may be a strong association with high doses of this medication. This relationship varies according to the type of drug, the dose, and the patient’s sex.
The expansion of GLP-1 drug use highlights the urgent need for in-depth studies that monitor patient safety over the long term. This is crucial for guiding doctors, specialists, and health policymakers in balancing therapeutic benefits against possible risks.
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