Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesity
Abstract Background Obesity affects over one billion people worldwide and is associated with ocular complications, yet comparative effects of newer anti-obesity medications on eye health remain poorly understood. We examine ocular health outcomes among individuals with obesity receiving Tirzepatide,...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-08-01
|
| Series: | Communications Medicine |
| Online Access: | https://doi.org/10.1038/s43856-025-01066-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849761346442231808 |
|---|---|
| author | Yu-Nan Huang Jo-Ching Chen Pin-Hung Li Min-Yen Hsu Chun-Wen Cheng Gideon Meyerowitz-Katz Pen-Hua Su |
| author_facet | Yu-Nan Huang Jo-Ching Chen Pin-Hung Li Min-Yen Hsu Chun-Wen Cheng Gideon Meyerowitz-Katz Pen-Hua Su |
| author_sort | Yu-Nan Huang |
| collection | DOAJ |
| description | Abstract Background Obesity affects over one billion people worldwide and is associated with ocular complications, yet comparative effects of newer anti-obesity medications on eye health remain poorly understood. We examine ocular health outcomes among individuals with obesity receiving Tirzepatide, Semaglutide, Phentermine/Topiramate, Naltrexone/Bupropion, or Phentermine monotherapy. Methods This propensity-score matched cohort study analyzed TriNetX US network data from November 2023 through April 2025. The study included matched pairs of obese individuals with a BMI ≥ 27 kg/m², comparing ocular outcomes between different anti-obesity medications. Primary outcomes included cataracts, oculomotor binocular dysfunction, visual disturbances, dry eye disease, ametropic accommodative dysfunction, and visual issues with blindness, assessed through Cox proportional hazards models with Bonferroni correction. Sensitivity analyses included BMI ≥ 30 kg/m² populations, subgroup stratification by clinical characteristics, and negative control outcomes to assess residual bias. Results Here, we show that among 25,060 matched pairs comparing Tirzepatide with Semaglutide, no differences emerge across ocular outcomes. When compared with Naltrexone/Bupropion, Tirzepatide users show lower rates of cataracts (HR 0.46, 95% CI 0.23–0.92, p = 0.025) and oculomotor dysfunction (HR 0.31, 95% CI 0.16–0.60, p = 2.3 × 10−4). Semaglutide demonstrates similar patterns. Both medications show favorable profiles for visual disturbances, with Tirzepatide demonstrating lower rates versus Phentermine (HR 0.45, 95% CI 0.31–0.68, p = 7 × 10−5). Sensitivity analyses in the BMI ≥ 30 kg/m² population yield consistent results. Conclusions Newer anti-obesity medications demonstrate differential associations with ocular outcomes compared to traditional agents. These findings may inform clinical decision-making regarding medication selection in obesity management, though prospective studies remain necessary to establish causal relationships. |
| format | Article |
| id | doaj-art-b43884e3974a4dbb9ab93f9d1eaaf27a |
| institution | DOAJ |
| issn | 2730-664X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Communications Medicine |
| spelling | doaj-art-b43884e3974a4dbb9ab93f9d1eaaf27a2025-08-20T03:06:04ZengNature PortfolioCommunications Medicine2730-664X2025-08-015111010.1038/s43856-025-01066-4Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesityYu-Nan Huang0Jo-Ching Chen1Pin-Hung Li2Min-Yen Hsu3Chun-Wen Cheng4Gideon Meyerowitz-Katz5Pen-Hua Su6Department of Pediatrics, Chung Shan Medical University HospitalDepartment of Pediatrics, Chung Shan Medical University HospitalDepartment of Pediatrics, Chung Shan Medical University HospitalSchool of Medicine, Chung Shan Medical UniversityInstitute of Medicine, Chung Shan Medical UniversitySchool of Health and Society, University of WollongongDepartment of Pediatrics, Chung Shan Medical University HospitalAbstract Background Obesity affects over one billion people worldwide and is associated with ocular complications, yet comparative effects of newer anti-obesity medications on eye health remain poorly understood. We examine ocular health outcomes among individuals with obesity receiving Tirzepatide, Semaglutide, Phentermine/Topiramate, Naltrexone/Bupropion, or Phentermine monotherapy. Methods This propensity-score matched cohort study analyzed TriNetX US network data from November 2023 through April 2025. The study included matched pairs of obese individuals with a BMI ≥ 27 kg/m², comparing ocular outcomes between different anti-obesity medications. Primary outcomes included cataracts, oculomotor binocular dysfunction, visual disturbances, dry eye disease, ametropic accommodative dysfunction, and visual issues with blindness, assessed through Cox proportional hazards models with Bonferroni correction. Sensitivity analyses included BMI ≥ 30 kg/m² populations, subgroup stratification by clinical characteristics, and negative control outcomes to assess residual bias. Results Here, we show that among 25,060 matched pairs comparing Tirzepatide with Semaglutide, no differences emerge across ocular outcomes. When compared with Naltrexone/Bupropion, Tirzepatide users show lower rates of cataracts (HR 0.46, 95% CI 0.23–0.92, p = 0.025) and oculomotor dysfunction (HR 0.31, 95% CI 0.16–0.60, p = 2.3 × 10−4). Semaglutide demonstrates similar patterns. Both medications show favorable profiles for visual disturbances, with Tirzepatide demonstrating lower rates versus Phentermine (HR 0.45, 95% CI 0.31–0.68, p = 7 × 10−5). Sensitivity analyses in the BMI ≥ 30 kg/m² population yield consistent results. Conclusions Newer anti-obesity medications demonstrate differential associations with ocular outcomes compared to traditional agents. These findings may inform clinical decision-making regarding medication selection in obesity management, though prospective studies remain necessary to establish causal relationships.https://doi.org/10.1038/s43856-025-01066-4 |
| spellingShingle | Yu-Nan Huang Jo-Ching Chen Pin-Hung Li Min-Yen Hsu Chun-Wen Cheng Gideon Meyerowitz-Katz Pen-Hua Su Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesity Communications Medicine |
| title | Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesity |
| title_full | Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesity |
| title_fullStr | Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesity |
| title_full_unstemmed | Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesity |
| title_short | Comparative ocular outcomes of tirzepatide versus other anti-obesity medications in people with obesity |
| title_sort | comparative ocular outcomes of tirzepatide versus other anti obesity medications in people with obesity |
| url | https://doi.org/10.1038/s43856-025-01066-4 |
| work_keys_str_mv | AT yunanhuang comparativeocularoutcomesoftirzepatideversusotherantiobesitymedicationsinpeoplewithobesity AT jochingchen comparativeocularoutcomesoftirzepatideversusotherantiobesitymedicationsinpeoplewithobesity AT pinhungli comparativeocularoutcomesoftirzepatideversusotherantiobesitymedicationsinpeoplewithobesity AT minyenhsu comparativeocularoutcomesoftirzepatideversusotherantiobesitymedicationsinpeoplewithobesity AT chunwencheng comparativeocularoutcomesoftirzepatideversusotherantiobesitymedicationsinpeoplewithobesity AT gideonmeyerowitzkatz comparativeocularoutcomesoftirzepatideversusotherantiobesitymedicationsinpeoplewithobesity AT penhuasu comparativeocularoutcomesoftirzepatideversusotherantiobesitymedicationsinpeoplewithobesity |