Statins and the progression of age-related macular degeneration in the United States.

Autor: Ludwig CA; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America.; Department of Ophthalmology, Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States of America., Vail D; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America., Rajeshuni NA; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America., Al-Moujahed A; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America., Rosenblatt T; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America., Callaway NF; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America., Veerappan Pasricha M; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America., Ji MH; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America., Moshfeghi DM; Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Aug 04; Vol. 16 (8), pp. e0252878. Date of Electronic Publication: 2021 Aug 04 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0252878
Abstrakt: Purpose: To study the effect of statin exposure on the progression from non-exudative to exudative age-related macular degeneration (AMD).
Methods: Retrospective cohort study of commercially insured patients diagnosed with non-exudative AMD (n = 231,888) from 2007 to 2015. Time-to-event analysis of the association between exposure to lipid-lowering medications and time from non-exudative AMD to exudative AMD diagnosis was conducted. Outcome measures included progression to exudative AMD, indicated by diagnosis codes for exudative AMD or procedural codes for intravitreal injections.
Results: In the year before and after first AMD diagnosis, 11,330 patients were continuously prescribed lipid-lowering medications and 31,627 patients did not take any lipid-lowering medication. Of those taking statins, 21 (1.6%) patients were on very-high-dose lipophilic statins, 644 (47.6%) on high-dose lipophilic statins, and 689 (50.9%) on low-dose lipophilic statins. We found no statistically significant relationship between exposure to low (HR 0.89, 95% CI 0.83 to 1.38) or high-dose lipophilic statins (HR 1.12, 95% CI 0.86 to 1.45) and progression to exudative AMD. No patients taking very-high-dose lipophilic statins converted from non-exudative to exudative AMD, though this difference was not statistically significant due to the subgroup size (p = .23, log-rank test).
Conclusions: No statistically significant relationship was found between statin exposure and risk of AMD progression. Interestingly, no patients taking very-high-dose lipophilic statins progressed to exudative AMD, a finding that warrants further exploration.
Competing Interests: Darius M. Moshfeghi is a co-founder with equity and serves on the board of directors of Linc, Inc a company that has developed a novel statin molecule that among other things may be targeted for AMD. Additionally, Darius M. Moshfeghi has the following conflicts of interest: 1-800 Contacts (board of directors, equity), Akceso Advisors AG (evaluation of DME market), Akebia (scientific advisory board for ROP), Alcon (data safety monitoring board for HAWK/HARRIER), Aldeyra Therapeutics (Site PI: ADX-2191-PVR-001 GUARD), Allegro (scientific advisory board), Apellis (Site PI: APL2-303 DERBY), Bayer Pharma AG (ROP imaging committee), CMEOutfitters.com (CME consultant), Cole Eye Institute (CME consultant), Congruence medical solutions (consultant), dSentz, Inc. (founder, board of directors, equity), Genentech (PROPER grant 2019), Grand Legend Technology, LTD (equity), Iconic Therapeutics (steering committee, unpaid), Irenix (scientific advisory board, unpaid), Northwell Health (grand rounds), Novartis Pharmaceuticals (data safety monitoring board for HAWK/HARRIER, KITE/KESTREL, China nAMD/DME, pediatric advisory board), Ocular Surgery News (consultant), Pr3vent (founder, board of directors, equity), Praxis UNS, Inc. (consultant), Prime Medical Education (CME consultant), Promisight, Inc. (founder, board of directors, equity), Pykus (scientific advisory board, equity), Regeneron (CME consultant, ROP steering committee, PI for ROP trial), Research to Prevent Blindness, Inc. (unrestricted departmental grant), Retina Technologies LLC (advisor, consultant), Retina Today/Pentavision (consultant), Shapiro Law Group (ROP expert witness), SLACK, Inc. (CME consultant), University of Miami (CME consultant), VersI, Inc. (founder, equity), Vindico (CME consultant), Visunex (scientific advisory board, equity. None of the other authors have any conflicts of interest to report. The above funders did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje