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Halili A, Haxha S, Zareini B, Lund-Andersen C, Kold Sørensen K, Torp-Pedersen C, Eroglu TE, Bang CN. Association between long-term statin use and cataract surgery: a nationwide study on 505 105 cataract surgery patients. Br J Ophthalmol 2024:bjo-2022-322409. [PMID: 39054053 DOI: 10.1136/bjo-2022-322409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 07/14/2024] [Indexed: 07/27/2024]
Abstract
AIMS To assess the association between statin use and cataract surgery according to different statin treatment durations in patients with different cardiovascular risk profiles. METHODS AND RESULTS We performed a nested case-control study using Danish registries, covering the period from 1 January 1996 to 31 December 2020. We defined cases as surgically treated cataract patients, matched in a 1:1 ratio by sex and age with controls not undergoing cataract surgery. The exposure of interest was statin use in different durations (1, 5 and 10 years) compared with never use of statins. Conditional logistic regression provided adjusted HRs and corresponding 95% CIs in subgroups defined by established atherosclerotic cardiovascular disease, diabetes, hypertension and individuals without these comorbidities. We identified 505 150 cataract surgery cases and found no increased HR of cataract surgery with statin treatment at any duration in any of the subgroups with established atherosclerotic cardiovascular disease, diabetes or hypertension. CONCLUSION Our findings do not support a possible association between long-term statin use and cataract in patients with established atherosclerotic cardiovascular disease, diabetes or hypertension. Although we found an association between statin use and cataract in individuals without these comorbidities, increasing durations of statin use did not yield higher cataract surgery rates.
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Affiliation(s)
- Andrim Halili
- Cardiology, Bispebjerg Hospital, Koebenhavn, Denmark
- Cardiology, North Zealand Hospital, Hilleroed, Denmark
| | - Saranda Haxha
- Cardiology, Bispebjerg Hospital, Koebenhavn, Denmark
- Cardiology, North Zealand Hospital, Hilleroed, Denmark
| | - Bochra Zareini
- Cardiology, North Zealand Hospital, Hilleroed, Denmark
- Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Christian Torp-Pedersen
- Cardiology, North Zealand Hospital, Hilleroed, Denmark
- Public Health, University of Copenhagen, Copenhagen, Denmark
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Yang HL, Byun SJ, Park S, Lee SH, Park SJ, Jung SY. Antihypertensive Use and the Risk of Cataract in Patients with Hypertension: A Nationwide Case-control Study. Ophthalmic Epidemiol 2023; 30:499-508. [PMID: 36369827 DOI: 10.1080/09286586.2022.2145612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/24/2022] [Accepted: 11/04/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE This study aims to investigate the association between antihypertensive use and the risk of cataract in a matched case-control study. METHODS We analysed the Korean National Health Insurance Service-Health Screening Cohort database from 2002 to 2013. We defined 'cases' as patients prescribed antihypertensives and underwent their first eye cataract surgery between 2010 and 2013. 'Controls' were patients prescribed antihypertensives and no history of cataract surgery or diagnosis between 2002 and 2013. Four controls were matched to each case by several variables. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated for cataract risk using a conditional logistic regression model after adjustment. RESULTS The analyses comprised 12,166 cases and 48,664 controls. The adjusted ORs for cataracts were 1.18 (95% CI: 1.12-1.24) in thiazide diuretics, 1.12 (95% CI: 1.07-1.18) in beta-blockers, 0.94 (95% CI: 0.90-1.00) in calcium channel blockers, 1.22 (95% CI: 1.14-1.30) in angiotensin-converting enzyme (ACE) inhibitors, and 0.97 (95% CI: 0.91-1.03) in angiotensin II receptor blockers compared to 'non-use' of each antihypertensive. CONCLUSION In a nationwide case-control study, the use of thiazide diuretics, beta-blockers, or ACE inhibitors do not represent minimal clinical important difference in the risk of cataract and the use of calcium channel blockers or angiotensin II receptor blockers is not associated with an increased risk of cataracts compared to non-use of each antihypertensive. Given the benefits of treating hypertension, such as the reduction in further complications, we suggest there is no need to change current clinical practice for antihypertensives.
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Affiliation(s)
- Hye Lim Yang
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Seong Jun Byun
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Sewon Park
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Sung Hoon Lee
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Sang Jun Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Sun-Young Jung
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
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Maumus-Robert S, Jarne-Munoz A, Pariente A, Duroux T, Duranteau L, Bezin J. Statin treatment is not associated with an increased risk of adrenal insufficiency in real-world setting. Front Endocrinol (Lausanne) 2023; 14:1254221. [PMID: 37818086 PMCID: PMC10561645 DOI: 10.3389/fendo.2023.1254221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/08/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction Statins could reduce the synthesis of steroid hormones, thereby could cause adrenal insufficiency. We investigated this risk in a large nationwide database. Methods We conducted a nested case-control study using a cohort of individuals affiliated to the French health insurance system in 2010, ≥18y and without adrenal insufficiency history. Each case had a first event of adrenal insufficiency between 2015 and 2017 and was matched to up to ten controls on age, sex, and prior treatment with corticosteroids. Statin exposure was measured over the five years preceding the index date, considering a six-month censoring lag-time. Association was estimated using a conditional logistic regression adjusted for confounders included in a disease risk score. Analyses were stratified on age, sex and corticosteroid history of use. Results 4 492 cases of adrenal insufficiency were compared with 44 798 controls (median age 66y, 58% women), of which 39% vs. 33% were exposed to statins, respectively. No association between statin use and adrenal insufficiency was found when adjusting the model for confounders (adjusted odds ratio 0.98; 95% confidence interval 0.90-1.05). These results were consistent regardless of the exposure definition and stratifications considered. Conclusion Statin-related adrenal insufficiency risk, if any, seems to be very limited and does not compromise the benefit of statin treatment.
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Affiliation(s)
- Sandy Maumus-Robert
- University Bordeaux, INSERM, Bordeaux Population Health (BPH), Team AHeaD, Bordeaux, France
| | - Ana Jarne-Munoz
- University Bordeaux, INSERM, Bordeaux Population Health (BPH), Team AHeaD, Bordeaux, France
| | - Antoine Pariente
- University Bordeaux, INSERM, Bordeaux Population Health (BPH), Team AHeaD, Bordeaux, France
- CHU de Bordeaux, Clinical Pharmacology Unit, INSERM, Bordeaux, France
| | - Thomas Duroux
- Health Information Department, ELSAN Group, Paris, France
| | - Lise Duranteau
- Medical Gynaecology Department, AP-HP Paris Saclay University, Bicêtre Hospital, Paris, France
| | - Julien Bezin
- University Bordeaux, INSERM, Bordeaux Population Health (BPH), Team AHeaD, Bordeaux, France
- CHU de Bordeaux, Clinical Pharmacology Unit, INSERM, Bordeaux, France
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Deng R, Zhu Z, Han X, Shang X, He M, Xu G, Chen Z, Fan H. Evaluation of Systemic Medications Associated With Surgically Treated Cataract Among US Adults. Am J Ophthalmol 2023; 249:126-136. [PMID: 36646239 DOI: 10.1016/j.ajo.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/24/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023]
Abstract
PURPOSE To comprehensively determine the associations between systemic medications and surgically treated cataract in the US population. DESIGNS Retrospective cross-sectional study. METHODS Participants aged ≥40 years from the 1999-2008 National Health and Nutrition Examination Survey (NHANES) were included. Surgically treated cataract was defined as cataract requiring a procedure. Data on prescription drug use over the past 30 days were collected via home interviews. Drug categories for ophthalmic indications and those prescribed in less than 0.5% of the participants were excluded from the analysis. Separate logistic regression models were used to explore associations between each drug category and surgically treated cataract. The Benjamin-Hochberg procedure was used to control the false discovery rate. RESULTS A total of 14,931 were included in the present analysis. The weighted prevalence of surgically treated cataract was 9.6% (n=2010). We identified 20 drug categories that had significant associations with surgically treated cataract, of which 8 associations remained statistically significant after further adjustment for pertinent comorbidities. The 3 drug categories with the highest odds ratio (OR) values were tricyclic antidepressants (OR, 2.21; 95% CI, 1.38-3.51; P = .001), insulin (OR, 2.13; 95% CI, 1.48-3.07; P = 9.41×10-5) and group III antiarrhythmic agents (OR, 2.00; 95% CI, 1.25-3.19; P = .004). The use of sex hormone combinations among women reduced the risk of having surgically treated cataract (OR, 0.011; 95% CI, 0.001-0.089; P = 5.98×10-5). Dose-response relationships were observed for all 8 drug categories. CONCLUSIONS Our comprehensive evaluation provides new knowledge on the complex relationships between systemic medications and surgically treated cataract.
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Affiliation(s)
- Ruidong Deng
- From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Z.Z., X.H., X.S., M.H.), Guangzhou, China; Ophthalmology, Department of Surgery, University of Melbourne (Z.Z., M.H.), Melbourne, Australia
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Z.Z., X.H., X.S., M.H.), Guangzhou, China
| | - Xianwen Shang
- Ophthalmology, Department of Surgery, University of Melbourne (Z.Z., M.H.), Melbourne, Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Z.Z., X.H., X.S., M.H.), Guangzhou, China; Ophthalmology, Department of Surgery, University of Melbourne (Z.Z., M.H.), Melbourne, Australia
| | - Guihua Xu
- From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China
| | - Zilin Chen
- From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China
| | - Huiya Fan
- From the Department of Ophthalmology, Huizhou Central People's Hospital (R.D., G.X., Z.C., H.F.), Huizhou, China.
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JAK inhibitors and risk of major cardiovascular events or venous thromboembolism: a self-controlled case series study. Eur J Clin Pharmacol 2022; 78:1981-1990. [DOI: 10.1007/s00228-022-03402-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/07/2022] [Indexed: 11/03/2022]
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Cheng JQ, Shi QP, Ding F, Kong LT, Yu ML, Wang C. Liver function monitoring: a prospective nested case-control study of Salvia miltiorrhiza polyphenol injection. Sci Rep 2020; 10:3538. [PMID: 32103121 PMCID: PMC7044424 DOI: 10.1038/s41598-020-60608-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/14/2020] [Indexed: 11/09/2022] Open
Abstract
Instructions for Salvia miltiorrhiza polyphenol injections indicate abnormal liver function as an occasional adverse reaction, but the incidence of this adverse drug reaction (ADR) has increased in recent years. We assessed S. miltiorrhiza polyphenol ADRs by performing a nested case-control study(NCCS) and meta-analysis. In the NCCS, 2633 patients receiving this treatment in the First Affiliated Hospital of Bengbu Medical College were enrolled. Logistic regression models found that in 58 (2.2%) patients experiencing abnormal liver function, the risk for liver dysfunction was associated with sulfa drug allergy (OR = 7.874, 95%CI (1.280, 48.447), P = 0.026), payment methods (OR = 0.106, 95%CI (0.012, 0.934), P = 0.043), duration of administration (OR = 0.922, 95%CI (0.862, 0.986), P = 0.017), cefathiamidine (OR = 0.441, 95%CI (0.216, 0.900), P = 0.025), human serum albumin (OR = 1.958, 95%CI (1.011, 3.789), P = 0.046), Dazhu Rhodiola injection (OR = 2.599, 95%CI (1.112, 6.070), P = 0.027), or reduced glutathione (OR = 0.394, 95%CI (0.188, 0.826), P = 0.014). Meta-analysis of reports on S. miltiorrhiza polyphenol ADRs in controlled trials and other observational studies included 676 patients, of which 17 (2.17%; 95%CI (0.0105, 0.0358)) presented with liver dysfunction; associated ADR risk factors included co-administration of other drugs. Our NCCS and meta-analysis had similar ADR incidence rates, which were higher than the rate in the drug instructions. This study provides guidance for assessing liver dysfunction risks associated with S. miltiorrhiza polyphenol injections.
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Affiliation(s)
- Jin-Quan Cheng
- Department of Pharmacy, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.,School of Pharmacy, Bengbu Medical College, Bengbu, Anhui, China
| | - Qing-Ping Shi
- Department of Pharmacy, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China. .,School of Pharmacy, Bengbu Medical College, Bengbu, Anhui, China.
| | - Feng Ding
- Department of Pharmacy, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Ling-Ti Kong
- Department of Pharmacy, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.,School of Pharmacy, Bengbu Medical College, Bengbu, Anhui, China
| | - Mei-Ling Yu
- Department of Pharmacy, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.,School of Pharmacy, Bengbu Medical College, Bengbu, Anhui, China
| | - Can Wang
- School of Pharmacy, Bengbu Medical College, Bengbu, Anhui, China
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Despas F, Rousseau V, Lafaurie M, De Canecaude C, Durrieu G, Bagheri H, Montastruc F, Montastruc J. Are lipid‐lowering drugs associated with a risk of cataract? A pharmacovigilance study. Fundam Clin Pharmacol 2019; 33:695-702. [DOI: 10.1111/fcp.12496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/27/2019] [Accepted: 06/25/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Fabien Despas
- Faculty of Medicine, Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance, Pharmacoepidemiology and Drug Information, INSERM UMR 1027 Pharmacoepidemiology, Assessment of Drug Utilization and Drug Safety, CIC 1426 CHU Toulouse University Hospital Toulouse France
| | - Vanessa Rousseau
- Faculty of Medicine, Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance, Pharmacoepidemiology and Drug Information, INSERM UMR 1027 Pharmacoepidemiology, Assessment of Drug Utilization and Drug Safety, CIC 1426 CHU Toulouse University Hospital Toulouse France
| | - Margaux Lafaurie
- Faculty of Medicine, Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance, Pharmacoepidemiology and Drug Information, INSERM UMR 1027 Pharmacoepidemiology, Assessment of Drug Utilization and Drug Safety, CIC 1426 CHU Toulouse University Hospital Toulouse France
| | - Claire De Canecaude
- Faculty of Medicine, Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance, Pharmacoepidemiology and Drug Information, INSERM UMR 1027 Pharmacoepidemiology, Assessment of Drug Utilization and Drug Safety, CIC 1426 CHU Toulouse University Hospital Toulouse France
| | - Geneviève Durrieu
- Faculty of Medicine, Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance, Pharmacoepidemiology and Drug Information, INSERM UMR 1027 Pharmacoepidemiology, Assessment of Drug Utilization and Drug Safety, CIC 1426 CHU Toulouse University Hospital Toulouse France
| | - Haleh Bagheri
- Faculty of Medicine, Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance, Pharmacoepidemiology and Drug Information, INSERM UMR 1027 Pharmacoepidemiology, Assessment of Drug Utilization and Drug Safety, CIC 1426 CHU Toulouse University Hospital Toulouse France
| | - François Montastruc
- Faculty of Medicine, Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance, Pharmacoepidemiology and Drug Information, INSERM UMR 1027 Pharmacoepidemiology, Assessment of Drug Utilization and Drug Safety, CIC 1426 CHU Toulouse University Hospital Toulouse France
| | - Jean‐Louis Montastruc
- Faculty of Medicine, Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance, Pharmacoepidemiology and Drug Information, INSERM UMR 1027 Pharmacoepidemiology, Assessment of Drug Utilization and Drug Safety, CIC 1426 CHU Toulouse University Hospital Toulouse France
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Dai W, Tham YC, Chee ML, Majithia S, Poh S, Tan AG, Tao Y, Wang JJ, Cheng CY. Systemic medications and cortical cataract: the Singapore Epidemiology of Eye Diseases Study. Br J Ophthalmol 2019; 104:330-335. [PMID: 31272959 DOI: 10.1136/bjophthalmol-2019-314256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/13/2019] [Accepted: 05/27/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND/AIMS To evaluate the association between systemic medications and cortical cataract prevalence in an Asian population. METHODS The Singapore Epidemiology of Eye Diseases Study recruited 10 033 Chinese, Malay and Indian residents aged 40+ years living in Singapore. Information on medication use was collected at interview using questionnaires. The presence and severity of cortical cataract were assessed from lens photographs using the modified Wisconsin Cataract Grading System. Associations between medications and the presence of cortical cataract were assessed using logistic regression. Associations between medications and greater severity of cortical cataract (none, minimal, early and late) were assessed using ordinal logistic regression. RESULTS A total of 8965 participants were included, the mean age was 57.6 (SD=9.8) years, and 4555 (50.8%) were women. After adjusting for age, gender, ethnicity, body mass index, smoking status, socioeconomic status, hypertension, hyperlipidaemia, diabetes, duration of diabetes and cardiovascular disease, ACE inhibitors (OR=1.27; 95% CI 1.05 to 1.55), fibrates (OR=1.57; 95% CI 1.05 to 2.35), alpha-glucosidase inhibitors (AGIs) (OR=1.85; 95% CI 1.13 to 3.02) and insulin (OR=1.80; 95% CI 1.11 to 2.93) were significantly associated with the presence of cortical cataract. Further adjusting for concurrent medication use did not alter these associations. Consistently, the four medications were also associated with a greater severity level of cortical cataract. CONCLUSION ACE inhibitors, fibrates and AGIs were associated with increased prevalence of cortical cataract in this Asian population, independent of the presence of hypertension, hyperlipidaemia and diabetes, respectively. Whether they contribute to the risk of cortical cataract needs confirmation in longitudinal studies.
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Affiliation(s)
- Wei Dai
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Stanley Poh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Ava Grace Tan
- Centre for Vision Research,Department of Ophthalmology, The Westmead Institute for Medical Research, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
| | - Yijin Tao
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Department of Ophthalmology, The First AffiliatedHospital of Kunming Medical University, Kunming, China
| | - Jie Jin Wang
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore .,Department of Ophthalmology, Yong Loo Lin School of Medicine, National Universityof Singapore, Singapore, Singapore.,Ophthalmology & Visual Sciences Academic Clinical Program (EyeACP), Duke-NUS Medical School, Singapore, Singapore
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Alves C, Mendes D, Batel Marques F. Statins and risk of cataracts: A systematic review and meta-analysis of observational studies. Cardiovasc Ther 2019; 36:e12480. [PMID: 30597753 DOI: 10.1111/1755-5922.12480] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/21/2018] [Accepted: 12/28/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Two previous meta-analyses evaluated the risk of cataracts associated with statins, but did not include relevant studies suggesting a cataractogenic effect. AIMS The aim of this systematic review and meta-analysis of observational studies is to evaluate such association considering the latest published evidence. METHODS A literature search was conducted to identify observational, comparative studies evaluating the risk of developing cataracts in patients treated with statins. A meta-analysis was performed to estimate odds ratios (ORs). Results were stratified according to the following studies' subgroups: design, methodological quality, method of diagnosis of cataract, patients' age, and median follow-up. Meta-regressions evaluated the influence of the following risk factors: smoking, hypertension, corticosteroids, selective serotonin reuptake inhibitors (SSRI), diabetes mellitus, and cardiovascular disease. RESULTS Twenty-one studies were included. Treatment with statins was associated with an increased risk of cataracts [OR: 1.11 (95% CI: 1.02-1.21); P = 0.017; I2 = 97.5%]. This risk remained statistically significant among case-controls, good methodological quality studies, studies with length of follow-up ≥5 years and those which outcome was cataract surgery. Between-studies heterogeneity was high among all risk estimates. Meta-regressions identified an inverse relationship between the risk of cataracts and the proportion of diabetic patients in the studies. CONCLUSIONS The results point out an increased risk of cataract development with statins. However, since the magnitude of the effect is low and between-studies heterogeneity is high, the extent in which these results have impact on the benefit/risk ratio of statins is difficult to ascertain due to the uncertainty of the findings.
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Affiliation(s)
- Carlos Alves
- Laboratory of Social Pharmacy and Public Health, School of Pharmacy, University of Coimbra, Coimbra, Portugal.,CHAD-Centre for Health Technology Assessment and Drug Research, Coimbra Regional Pharmacovigilance Unit (UFC), AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Diogo Mendes
- CHAD-Centre for Health Technology Assessment and Drug Research, Coimbra Regional Pharmacovigilance Unit (UFC), AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Francisco Batel Marques
- Laboratory of Social Pharmacy and Public Health, School of Pharmacy, University of Coimbra, Coimbra, Portugal.,CHAD-Centre for Health Technology Assessment and Drug Research, Coimbra Regional Pharmacovigilance Unit (UFC), AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
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