A research team led by the Department of Medicine, under the School of Clinical Medicine, LKS Faculty of Medicine of the University of Hong Kong (HKUMed), has synergised impacts of worldwide clinical trial data through a series of meta-analyses on GLP‑1 receptor agonists, an emerging cardiometabolic drug, offering in-depth insights into its safety profile and novel therapeutic potential in treating cardiovascular diseases. The study found that there was no definite risk of ischaemic optic neuropathy associated with GLP-1 agonist use in patients with diabetes or heart diseases. It also revealed that cardiac patients with obesity may improve the long-term success rate of curative catheter ablation for atrial fibrillation by adopting various weightcontrol measures, along with appropriate medication. These findings will help frontline clinicians perform more comprehensive risk‑benefit assessments before prescribing medications.
HKUMed study finds no clear link between GLP‑1 use and ischaemic optic neuropathy, and shows that obese cardiac patients may improve long‑term atrial fibrillation ablation outcomes through weight control along with appropriate medication. Photo source: HKUMed
Data from over 80,000 patients show no significant optic nerve risk from GLP-1 therapy
GLP-1 receptor agonists are an emerging class of therapeutics for treating obesity, diabetes and cardiometabolic diseases. As their clinical use continues to expand, concerns about their potential side effects have emerged. Previous research indicated a possible link between GLP-1 receptor agonists and ischaemic optic neuropathy, a serious ocular complication that can cause sudden, painless vision loss and visual field defects, particularly among individuals with diabetes and hypertension. However, evidence regarding this risk has remained inconsistent and at times conflicting.
In view of this, HKUMed conducted a meta-analysis to evaluate the safety profile and therapeutic potential of GLP-1 receptor agonists. The team analysed global clinical trial data comprising more than 80,000 patients with diabetes and heart disease, representing the largest sample size examined in this field to date. The findings showed no significant association between the use of GLP-1 receptor agonists and the risk of adverse vision-threatening complications, providing clearer evidence for formulating clinical treatment plans and enabling doctors to comprehensively assess the benefits and risks of these medications.
Integrated weight management and medication improve surgical success
Obesity increases the risk of developing cardiovascular diseases, such as atrial fibrillation (AF), which is the most common cardiac arrhythmia encountered in clinical practice and can result in life-threatening complications, including stroke and heart failure. In another study, the team analysed data from 5,415 patients with atrial fibrillation and found that for individuals with obesity, every 1% reduction in weight was associated with a 6.3% reduction in the relative risk in AF recurrence after catheter ablation. This highlights that sustained weight control is a critical factor in operative success.
Cardiac patients with obesity may improve the long-term success rate of catheter ablation for atrial fibrillation though a holistic approach to weight control, including adopting a healthier lifestyle and incorporating other clinical interventions, together with GLP-1 receptor agonists. Optimal treatment outcomes require patients to adopt a comprehensive cardiovascular risk management strategy, rather than relying solely on medication.
The findings were published in the latest issue of Diabetes Care, which is the journal of the American Diabetes Association, and were presented at the European Heart Rhythm Association Congress in Vienna in 2025.
Data‑driven insights help doctors evaluate new drugs
Lead investigator Dr Will Chan Yap-hang, Clinical Assistant Professor, Department of Medicine, School of Clinical Medicine, HKUMed, said, ‘Our meta-analysis of clinical trial data provides important evidence regarding both the safety profile and novel use of GLP-1 receptor agonists in cardiovascular patients. This will help doctors more comprehensively evaluate the potential risks and benefits of prescribing these medications. However, this research does not completely rule out the possibility of rare adverse complications. Clinicians must exercise careful judgement based on each patient’s condition. It is essential not to overemphasise the potential benefits while overlooking the associated risks, and to always assess the situation holistically.’
About the research team
This interdisciplinary study was co-led by Dr Will Chan Yap-hang, Clinical Assistant Professor, and Professor Tse Hung-fat, Chair Professor and Department Chairperson, both from the Department of Medicine, School of Clinical Medicine, HKUMed. The first author is Ms Kathleen Li Hoi-ying. Other team members include Professor Yiu Kai-hang, Clinical Professor, Department of Medicine, and Dr Kendrick Co Shih, Clinical Associate Professor of Practice, Department of Ophthalmology, both from the School of Clinical Medicine, HKUMed.
HKUMed evaluates the safety profile and therapeutic potential of GLP-1 receptor agonists by analysing global clinical trial data comprising more than 80,000 patients with diabetes and heart disease. The research is led by Dr Will Chan Yap-hang (second right) and Professor Tse Hung-fat (middle). Photo source: HKUMed
Liver cancer is the sixth most common cancer worldwide and the third leading cause of cancer-related deaths. A recent report published in 'The Lancet' predicts that the number of new liver cancer cases will increase from 870,000 in 2022 to 1.52 million by 2050, nearly doubling the figure. If the current trend continues, this increase could result in 1.37 million deaths.
Traditional cancer therapies often overlook patient-specific and dynamic tumor immune environments, causing ineffective treatments, toxic side effects, and critical delays. The University of Hong Kong (HKU) has developed 'Liver-in-Cube', the world's first 3D-bioprinted platform that precisely reconstructs the liver cancer microenvironment in the lab using a patient's own cells and extracellular matrix. This platform offers a fast and reliable service to help patients identify the most effective personalised treatments and pave the way for a standardised, high-throughput solution for drug assessment and development.
The invention can accurately simulate tumour characteristics of individual patients, such as the cell numbers, tissue stiffness and immune microenvironments, enabling doctors to swiftly assess the efficacy and side effects of various drugs and emerging therapies, leading to more precise treatment decision. This technology has received the ‘Gold Medal’ at the International Exhibition of Inventions of Geneva, ‘Special Grand Prize’ at Prize of the China Invention Association, and ‘Best-Performing Start-Up Award’at Asia Summit on Global Health (ASGC) Conference.
The technology has received the ‘Gold Medal’ at the International Exhibition of Inventions of Geneva, ‘Special Grand Prize’ at Prize of the China Invention Association, and ‘Best-Performing Start-Up Award’at Asia Summit on Global Health (ASGC)Conference. Photo source: HKUMed
From ‘Trials to Tailored Treatment’: Seizing the Golden Treatment Window
Currently, there is a lack of personalised drug-screening platforms for liver cancer treatment in the market, which often makes patients undergo multiple treatment failures in the search for the most suitable drug. This not only imposes a heavy financial burden but may also delay the timing in killing the tumour cells effectively. The 'Liver-in-Cube' directly addresses this pain point by accelerating the evaluation of the efficacy and side effects of various drugs for patients, allowing doctors to identify the optimal treatment method for patients and reducing the risk of cancer recurrence due to treatment delays. The ‘Liver-in-Cube' has now started patient recruitment at local hospitals to expedite clinical trials and advance its transition into clinical application.
The 'Liver-in-Cube' developed by HKU, Photo source: HKUMed
Dual Value in Clinical and Research Excellence
Professor Man Kwan, Chair Professor in the Department of Surgery, School of Clinical Medicine, HKUMed, who led the research project, stated that ‘Liver-in-Cube' can speed up the identification of the most effective drugs for patients, significantly enhancing treatment efficiency and reducing side effects, with the potential to greatly improve patient survival rates. In pharmaceutical development, the technology serves as a substitute for animal models, accelerating preclinical efficacy and safety testing for new drugs with more accurate data to increase the success rate of further clinical trials. This invention can shorten the new drug development cycle with reducing costs. In the field of basic research, the model assists researchers in exploring immune regulation mechanisms and discovering new therapeutic targets and strategies. The application prospects of the ‘Liver-in-Cube' are extensive, and its technological framework can be expanded to other liver diseases and cancers, promoting the widespread adoption of precision medicine. Currently, the technology is undergoing clinical trials in local public and private hospitals. The team aims to leverage the scientific data to facilitate the commercialisation of the technology and make it available in both local and overseas markets, thus benefitting a wide range of patients.
The University of Hong Kong (HKU) has developed‘Liver-in-Cube’,the world’s frst 3D-bioprinted platform that precisely reconstructs the liver cancer microenvironment in the lab using a patient’s own cells and extracellular matrix. Photo source: HKUMed
Five core technologies of ‘Liver-in-Cube':
• 1. Novel Technology for Cell and Matrix Protein Separation: Simultaneously extracts hepatocytes, tumor cells, immune cells, and matrix proteins from the tissue of the liver cancer patient, accurately simulating individual tumor characteristics.
• 2. Advanced 3D Bioprinting: Creates a biomimetic model incorporating normal tissue, tumor tissue, and vascular structures, surpassing traditional 3D cell culture and organoid products in reproducing a patient's tumor architecture.
• 3. AI-assisted patient parameterisation and printing: Utilising AI models trained on clinical biobanks, we correlate pathological features, tissue stiffness, and tumor immune microenvironment subtypes to determine the optimal geometric structure and bio-ink composition for each patient.
• 4. Customised patient-specific tumor characterisation system: By precisely measuring patient-specific parameters such as tumor stiffness and immune profiles, we reconstruct a highly biomimetic, individualized tumor microenvironment for each patient.
• 5. Innovative Tumor Model with Microvascular System: Enables continuous drug testing and evaluation of various therapies, enhancing the assessment of treatment effects in a laboratory setting.
Led by Professor Man Kwan from the Department of Surgery, HKUMed, the research
team focuses in the study of postoperative recurrence and immune microenvironment
of liver cancer. Over the decades, the team has become internationally recognised as
the leading force in the fields of liver oncology, transplant oncology, and transplant
immunology.
