Wegovy for Dry Eye? Maybe

You started them for diabetes or weight loss but you stayed for the anti-inflammatory benefits. Now the hot new weight loss medications: semaglutide (trade names Ozempic, Wegovy) and tirzepatide (Mounjaro which is currently being fast-tracked for weight loss) are showing another potential side: anti-inflammatory actions that are working on everything from psoriasis to vascular inflammation and is even purported to potentially help with the overwhelming inflammation that can occur with COVID infection.

We know that low grade inflammation contributes to obesity and the pathophysiology of type 2 diabetes and that it is self-amplifying and self-perpetuating. Recent case reports have shown significant improvements in autoimmune conditions including plaque psoriasis even when that individual patient had been resistant to newer biologic therapies.[i]

How does it work? Certainly, by reducing fat cells and stimulating the “browning” of subcutaneous fat (increasing the use of fat for heat instead of energy storage), inflammation can be directly reduced.[ii] However, GLP-1 agonists have extra-pancreatic effects apart from insulinotropic acions: they can suppress inflammatory cell proliferation and influence a multitude of immunoregulatory functions, decreasing IL-17, TNF-alpha and IL-6. All are markers that can be associated with the inflammation of dry eye.

Could a diabetes drug help patients suffering with dry eye symptoms? Possibly. Larger studies are currently underway looking at long-term cardiovascular health and inflammation in diabetic and obese patients using the medications. Anecdotally, many rheumatoid arthritis, fibromyalgia patients and general peri and post-menopausal patients are reporting improved symptoms and function which is most intriguing because patients experienced improved CRP (C-reactve protein a marker for inflammation) measurements REGARDLESS of baseline BMI, body weight or glycemic status. [iii]

We’ve only just begun to scratch the surface to understand how these medications may be useful to not only those with diabetes or overweight but also those suffering with chronic inflammatory conditions like autoimmune diseases and even dry eye. This exciting new research opens the door to more exploration. Stay tuned for more information.

[i] Costanzo, G, Salvatore Curatolo, Barbara Busa, Antonino Belfiore and Damiano Gullo, “Two birds with one stone: semaglutide is highly effective against severe psoriasis in a Type 2 diabetic patient” Endocrnology, Diabetes and Metabolism Case Reports, 31 Aug 2021

[ii] Martins, F, thatiany S marinho, Luiz E M Cardoa, Sandra Barbosa-da-Silva, Vanessa Souza-Mello, Marcia B Aguila, Carols A Mandarim-de-Lacerda, “SEmaglutide (GLP-1 receptor agonist) stimulates browning on subcutaneous fat adiposytes and mitigates inflammation and endoplasmic reticulum stress in visceral fat adipocytes of obese mice,

[iii] Zobel, EH, Ripa, RS, vonScholten, BJ et al. “Effect of liraglutide on expression of inflammatory genes in type 2 diabetes, Sci Rep, 11, 18522.