What is the absolute risk of someone developing nephrotoxicity (nion) while taking Zepbound (tirzepatide)?

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From the Research

The absolute risk of developing nonarteritic ischemic optic neuropathy (NION) while taking Zepbound (tirzepatide) is not directly established, but a related study on semaglutide, a similar GLP-1 receptor agonist, suggests an increased risk of NION, with a cumulative incidence of 8.9% over 36 months in patients with type 2 diabetes 1.

Key Points to Consider

  • Zepbound, a GLP-1/GIP receptor agonist, is approved for weight management and has common side effects including gastrointestinal symptoms.
  • Vision-related adverse events like NION have not been identified as a significant risk in clinical trials or post-marketing surveillance for Zepbound specifically.
  • However, the study on semaglutide indicates a higher risk of NAION in patients prescribed semaglutide compared to those prescribed non-GLP-1 RA medications, with a hazard ratio of 4.28 (95% CI, 1.62-11.29) in patients with type 2 diabetes 1.
  • If you're taking Zepbound and experience any vision changes such as sudden vision loss, blurring, or visual field defects, you should seek immediate medical attention.
  • Your healthcare provider should be informed about any pre-existing eye conditions before starting Zepbound, especially if you have risk factors for optic neuropathy such as diabetes, hypertension, or sleep apnea, which are common in patients who might be prescribed this medication.

Comparison with Other Medications

  • Other weight loss medications have had rare reports of vision complications, but the specific risk associated with Zepbound is not established.
  • A study comparing tirzepatide with semaglutide for the treatment of obesity found that tirzepatide was superior in reducing body weight and waist circumference, but did not report on the risk of NION 2.

Recommendations

  • Patients taking Zepbound should be monitored for any vision changes and report them immediately to their healthcare provider.
  • Healthcare providers should consider the potential risk of NION when prescribing Zepbound, especially in patients with risk factors for optic neuropathy.
  • Further studies are needed to establish the absolute risk of NION associated with Zepbound.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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