Lower incidence of diabetic retinopathy and worsening events after phentermine assisted weight loss across a large U.S. cohort.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Eye Pub Date : 2025-05-10 DOI:10.1038/s41433-025-03818-x

Madhukar Kumar, Nadia J Abbass, Matthew W Russell, Nikhil Das, Rishi P Singh, Katherine E Talcott

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引用次数: 0

Abstract

Background/objectives: Medication assisted weight loss for treatment of obesity has rapidly increased. The effect of this treatment with phentermine on diabetic retinopathy (DR) is underexplored.

Subjects/methods: Retrospective cohort study. The U.S. Collaborative Network of the TriNetX platform was queried for patients diagnosed with overweight and obesity and prescription of phentermine. Patients were propensity score matched across baseline demographics and systemic risk factors at the time of medication initiation and compared to those diagnosed with overweight and obesity without usage of weight loss medications, identifying 26,611 patients per cohort after propensity score matching. Risk ratios (RR) of incident DR and related diagnoses or procedural codes found after the medication initiation date for pertinent disease worsening and treatment metrics were assessed.

Results: Phentermine usage was found to be associated with reduced future risk of a new diagnosis of DR with macular oedema (RR 0.462; (95% CI 0.372-0.573), P < 0.001), mild non-proliferative diabetic retinopathy (NPDR) (RR 0.621 (0.508, 0.760), P < 0.001), moderate NPDR (RR 0.567 (0.402, 0.799), P < 0.001), severe NPDR (RR 0.477 (0.233, 0.981), P = 0.003), proliferative diabetic retinopathy (PDR) (RR 0.451 (0.323, 0.629), P < 0.001), vitreous haemorrhage (RR 0.347 (0.200, 0.602), P < 0.001), need for intravitreal anti-VEGF injection (RR: 0.530 (0.354, 0.793), P < 0.001).

Conclusion: The present analysis suggests that phentermine usage is associated with a decreased risk of diabetic macular oedema, NPDR, PDR, and worsening events.

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在美国一项大型队列研究中，芬特明辅助减肥后糖尿病视网膜病变和恶化事件的发生率较低。

背景/目的：药物辅助减肥治疗肥胖的方法迅速增加。芬特明治疗糖尿病视网膜病变（DR）的效果尚未得到充分探讨。对象/方法：回顾性队列研究。向TriNetX平台的美国协作网络查询诊断为超重和肥胖的患者以及芬特明的处方。在开始用药时，患者的倾向评分与基线人口统计学和系统性风险因素相匹配，并与那些被诊断为超重和肥胖但未使用减肥药的患者进行比较，在倾向评分匹配后，每个队列确定26,611名患者。评估开始用药日期后发生DR的风险比（RR）以及相关疾病恶化和治疗指标的相关诊断或程序代码。结果：芬特明的使用与DR合并黄斑水肿的新诊断风险降低相关(RR 0.462；结论：目前的分析表明，芬特明的使用与糖尿病黄斑水肿、NPDR、PDR和恶化事件的风险降低有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Eye 医学-眼科学

CiteScore

6.40

自引率

5.10%

发文量

481

审稿时长

3-6 weeks

期刊介绍： Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists. Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.