A cohort study published online in JAMA Ophthalmology on August 28 reports an association between prescriptions for glucagon-like peptide-1 receptor agonists (GLP-1RAs) and a lower incidence of noninfectious uveitis compared with matched controls. These findings suggest a potential anti-inflammatory benefit of GLP-1RAs, the study authors noted, warranting further investigation into their role in ocular inflammatory diseases.
Using the TriNetX electronic health record network, researchers analyzed records from 516,052 patients seen between 2006 and 2025. Each GLP-1RA–treated patient was propensity-score matched to a control patient on demographics, smoking status, hypertension, BMI, HbA₁c, and diabetic retinopathy stage. The GLP-1RA cohort exhibited a substantially lower risk of uveitis than controls (risk ratio, 0.48; 95% CI 0.46-0.51), a finding that held in subanalyses of patients with type 2 diabetes (RR 0.54; 95% CI 0.51-0.58) and those without diabetes (RR 0.52; 95% CI 0.46-0.59).
When compared with other diabetes therapies, GLP-1RAs were associated with greater reductions in uveitis risk than metformin (RR 0.58; 95% CI 0.54-0.62) and insulin (RR 0.57; 95% CI 0.54 to 0.61). However, GLP-1RA users had a slightly higher risk compared to those taking sodium–glucose cotransporter-2 inhibitors (SGLT2is) (RR 1.17; 95% CI 1.04 to 1.32), though SGLT2is themselves were linked to a lower uveitis risk vs controls (RR 0.52; 95% CI 0.48 to 0.56).
The study was conducted by Sumit Sharma, MD, of the Cole Eye Institute, Cleveland Clinic, as well as colleagues affiliated with Cole, Case Western Reserve University, MetroHealth Hospital, and the Lerner Research Institute in Cleveland, Ohio. The study was funded in part by the Clinical and Translational Science Collaborative of Cleveland, supported by a National Institutes of Health Clinical and Translational Science Award grant (UL1TR002548).
The finding of a lower uveitis risk among GLP-1RA recipients could have implications for managing patients with both metabolic disease and uveitis risk, although the retrospective design limits causal inference, the authors noted. As with many observational studies based on EHR data, residual confounding remains a concern. Prospective, controlled studies will be needed to determine whether GLP-1RAs possess direct anti-inflammatory effects in the eye, and whether these effects translate into clinical benefit in populations at risk for uveitis.
The authors concluded, “GLP-1RA prescriptions were associated with a lower risk of uveitis compared with controls. These findings suggest potential anti-inflammatory benefits beyond glycemic control, warranting further investigation into their role in ocular inflammatory diseases.” RP