GLP-1 Receptor Agonist Initiation and Anti-VEGF Treatment Frequency in Diabetic Macular Edema: an IRIS(R) Registry Cohort Study
- 1Massachusetts Eye and Ear Department of Ophthalmology, Harvard Medical School
Abstract
PurposeTo evaluate whether initiation of GLP-1 receptor agonists (GLP-1RAs) is associated with anti-VEGF treatment burden in type 2 diabetes patients with diabetic macular edema (DME) in the IRIS(R) Registry (Intelligent Research in Sight).
MethodsIncident GLP-1RA initiators were matched 1:1 with controls via Mahalanobis distance matching (9,896 pairs; N=19,792) on sociodemographics, DME risk factors, and factors influencing GLP-1RA prescription including hypertension, obesity, chronic kidney disease. A longitudinal mixed-effects event-study model evaluated monthly anti-VEGF injection frequency over a 36-month window (12 months before through 24 months after initiation), adjusting for DME duration. Visual acuity (VA) and central subfield thickness (CST) were secondary outcomes.
ResultsFollowing GLP-1RA initiation, anti-VEGF injection trajectories did not significantly differ between the matched GLP-1RA and control cohorts (interaction coefficients -0.18 to 1.59, P>0.05). Likewise, no differences in VA were observed between cohorts (-0.05 to 0.04 logMAR, P>0.05) or CST (-14.12 to 33.58 {micro}m, P>0.05).
ConclusionIn these matched cohorts, GLP-1RA initiation was not associated with the trajectory of anti-VEGF use or changes in VA or CST.
PrecisWe used the American Academy of Ophthalmology IRIS(R) Registry (Intelligent Research in Sight) to identify patients with DME. In 19,792 matched patients, there was no significant reduction in injection frequency post GLP1-RA initiation and no significant change in VA or CST.
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BibTeX
@misc{nagalamadaka2026glp1,
title = {{GLP-1 Receptor Agonist Initiation and Anti-VEGF Treatment Frequency in Diabetic Macular Edema: an IRIS(R) Registry Cohort Study}},
author = {P. Nagalamadaka and C. J. Ross and J. B. Gilbert and H. Stillman and S. Y. Ghauri and S. M. Dutton and W. Kearney and J. H. Li and A. Leong and R. P. Singh and M. G. Krzystolik},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.29.26361426},
url = {https://www.medrxiv.org/content/10.64898/2026.08.29.26361426v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - GLP-1 Receptor Agonist Initiation and Anti-VEGF Treatment Frequency in Diabetic Macular Edema: an IRIS(R) Registry Cohort Study
AU - P. Nagalamadaka
AU - C. J. Ross
AU - J. B. Gilbert
AU - H. Stillman
AU - S. Y. Ghauri
AU - S. M. Dutton
AU - W. Kearney
AU - J. H. Li
AU - A. Leong
AU - R. P. Singh
AU - M. G. Krzystolik
PY - 2026
DA - 2026/08/29
PB - medRxiv
DO - 10.64898/2026.08.29.26361426
UR - https://www.medrxiv.org/content/10.64898/2026.08.29.26361426v1
AB - PurposeTo evaluate whether initiation of GLP-1 receptor agonists (GLP-1RAs) is associated with anti-VEGF treatment burden in type 2 diabetes patients with diabetic macular edema (DME) in the IRIS(R) Registry (Intelligent Research in Sight). MethodsIncident GLP-1RA initiators were matched 1:1 with controls via Mahalanobis distance matching (9,896 pairs; N=19,792) on sociodemographics, DME risk factors, and factors influencing GLP-1RA prescription including hypertension, obesity, chronic kidney disease. A longitudinal mixed-effects event-study model evaluated monthly anti-VEGF injection frequency over a 36-month window (12 months before through 24 months after initiation), adjusting for DME duration. Visual acuity (VA) and central subfield thickness (CST) were secondary outcomes. ResultsFollowing GLP-1RA initiation, anti-VEGF injection trajectories did not significantly differ between the matched GLP-1RA and control cohorts (interaction coefficients -0.18 to 1.59, P>0.05). Likewise, no differences in VA were observed between cohorts (-0.05 to 0.04 logMAR, P>0.05) or CST (-14.12 to 33.58 {micro}m, P>0.05). ConclusionIn these matched cohorts, GLP-1RA initiation was not associated with the trajectory of anti-VEGF use or changes in VA or CST. PrecisWe used the American Academy of Ophthalmology IRIS(R) Registry (Intelligent Research in Sight) to identify patients with DME. In 19,792 matched patients, there was no significant reduction in injection frequency post GLP1-RA initiation and no significant change in VA or CST.
ER -