FDA orders vision-loss warning on GLP-1 drugs; heart meeting puts statins and BP targets to the test; AMA tells patients to ask their doctor first — Morning Medical Update

FDA orders vision-loss warning on GLP-1 drugs

The rare eye condition has been reported with every GLP-1 drug on the market.

The U.S. Food and Drug Administration (FDA) is requiring makers of all glucagon-like peptide-1 (GLP-1) receptor agonists to add a warning about non-arteritic anterior ischemic optic neuropathy (NAION), a rare condition that can cause sudden, painless vision loss in one eye, according to a Nov. 9 drug safety communication. The change covers semaglutide, tirzepatide, liraglutide, dulaglutide and orforglipron, among others.

In an FDA meta-analysis of 126 clinical trials, NAION occurred at a rate of 6.4 cases per 100,000 person-years in patients taking GLP-1 drugs, compared with 3.8 in patients on placebo or another glucose-lowering drug.

The agency’s own observational study found no significant increase in risk compared with SGLT2 inhibitors but did find one compared with DPP-4 inhibitors.

The FDA advises clinicians to tell patients to report sudden vision changes in one eye immediately, refer suspected cases to an ophthalmologist and consider stopping the drug in patients who develop NAION unless the benefits clearly outweigh the risk.

Heart meeting puts statins and BP targets to the test

Several closely watched trials came up neutral, though one blood pressure goal held up after stroke.

Adults 70 and older without heart disease who stopped taking statins saw no significant rise in heart attack, stroke or death at about two years in a trial of 1,880 patients presented at the American Heart Association’s Scientific Sessions 2026 in Chicago and published Nov. 7 in The New England Journal of Medicine.

With up to four years of follow-up, however, 12.7% of those who stopped had one of those events, compared with 9.2% of those who continued. Study author Rita F. Redberg, M.D., M.Sc., said “one cannot make a general recommendation about stopping statins in this patient population.”

Two trials tested a systolic target below 120 mm Hg. In OPTIMAL-STROKE, the tighter goal lowered the risk of major cardiovascular events by about 21% among 4,368 survivors of stroke or transient ischemic attack. In OPTIMAL-DIABETES, it made no significant difference among 9,476 adults with type 2 diabetes and was tied to more kidney-related events.

Two much-anticipated drugs fell short. Pelacarsen lowered lipoprotein(a) by 78% and the interleukin-6 inhibitor ziltivekimab cut inflammation markers, but neither reduced cardiovascular events. And in the Ez-PAVE trial, starting with a statin alone worked about as well as starting with a statin plus ezetimibe.

AMA tells patients to ask their doctor first

The new campaign takes aim at health advice from social media, online searches and chatbots.

The American Medical Association (AMA) launched a national campaign Nov. 9 urging patients to check with their physicians before acting on health advice from social media, online searches and artificial intelligence (AI) tools.

AMA President Willie Underwood III, M.D., M.Sc., M.P.H., FACS, introduced the “Have You Asked Your Doctor?” campaign in a video, saying the physician-patient relationship matters more than ever. Its tagline: “The web has millions of answers. Your doctor has yours.”

AMA CEO John Whyte, M.D., M.P.H., highlighted the campaign Nov. 6 at the opening of the AMA’s Interim Meeting in Orlando, Florida.

“This campaign reminds patients that physicians are essential partners in helping patients cut through the noise and make informed decisions,” he said. Resources on the campaign site include a guide to using AI chatbots for health along with information on vaccines and wearables.