Early worsening of diabetic retinopathy in individuals with type 2 diabetes treated with tirzepatide: a real-world cohort study
Main finding · New-onset proliferative DR (PDR) (grade R3M0, R3M1)Result — go to the resultOdds ratio 2.15 95% CI 1.24–3.74Authors' conclusion
Tirzepatide therapy resulted in significantly increased odds of incident PDR, particularly in individuals with mild NPDR with maculopathy (grade R1M1), or moderate-to-severe NPDR with or without maculopathy (grade R2M0, R2M1). The increase in odds of progression would justify specialist ophthalmologist referral by Early Treatment Diabetic Retinopathy Study (ETDRS) criteria.
Study context
- Population
- Individuals with T2D, matched for sex, diabetes duration, retinopathy status, HbA1c, number of retinal screening episodes and glucose-lowering medications; mean HbA1c 56.1 ± 15.8 mmol/molmatched cohort
- Participants
- 3,435 vs 3,434
- Exposure
- Tirzepatide-exposed vs tirzepatide-unexposed
- Tirzepatide-exposedn = 3,435
- Tirzepatide-unexposedn = 3,434reference
- Outcome
- New-onset proliferative DR (proliferative diabetic retinopathy (PDR)) (grade R3M0, R3M1)
Methodological detailsreal-world clinical data, matched 1:1, conditional logistic regression
- Real-world clinical data
- Matched 1:1
- Conditional logistic regression
Main finding
As reported in the abstract
Odds ratio
2.15
95% CI 1.24–3.74
P < 0.01
Events by group
Observational data: associations, not effects.
Further findings
New-onset retinopathy in those without DR (R0M0) at initiation
- Tirzepatide associated with reduced odds of new-onset retinopathy, OR
- 0.73 (0.62, 0.86), p<0.001 (95% CI)
- Multivariate analysis
Retinopathy progression in mild non-proliferative diabetic retinopathy (NPDR) (R1M0 or R1M1)
- Tirzepatide not significantly associated with retinopathy progression
Original publication
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