Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea.
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Drug Saf. 2020 Jun;43(6):539-547. doi: 10.1007/s40264-020-00914-7.
Theoretically, benzodiazepines (BZDs) can narrow the iridocorneal angle and induce acute angle-closure glaucoma (AACG). However, little evidence exists regarding this association.
The objective of this study was to assess whether the use of BZDs is associated with the risk of AACG.
We conducted a population-based case-crossover study using the nationwide claims database of the National Health Insurance Service in Korea. Patients with newly diagnosed AACG-between 1 January 2013 and 31 December 2016-who had received at least one BZD prescription prior to AACG diagnosis were enrolled. The date of AACG diagnosis was set as the index date. We assessed BZD use by each patient during a 30-day case period prior to the index date and three consecutive control periods that preceded this date. We used conditional logistic regression that adjusted for concomitant medications to determine the odds ratio for the use of BZDs in the case period compared with that in the control period in patients with incident AACG.
Of the 11,093 patients with incident AACG, 6709 received a prescription for BZD prior to diagnosis. BZD use was associated with an increased risk of AACG [adjusted odds ratio (aOR) = 1.40; 95% confidence interval (CI) 1.27-1.54]. AACG risk was similar for short-acting (aOR = 1.40, 95% CI 1.24-1.57) and long-acting BZDs (aOR = 1.33, 95% CI 1.18-1.50).
We found that BZD use was associated with AACG risk in the Korean population. Clinicians should carefully monitor the occurrence of visual disturbance in BZD-treated patients.
理论上,苯二氮䓬类药物(BZDs)可使房角变窄并诱发急性闭角型青光眼(AACG)。然而,关于这种关联的证据很少。
本研究旨在评估 BZD 的使用是否与 AACG 风险相关。
我们使用韩国国家健康保险服务的全国性索赔数据库进行了一项基于人群的病例交叉研究。纳入了 2013 年 1 月 1 日至 2016 年 12 月 31 日期间新诊断为 AACG 的患者,这些患者在 AACG 诊断前至少接受过一次 BZD 处方。AACG 诊断日期设为索引日期。我们评估了每位患者在索引日期前 30 天的病例期内和在此日期之前的三个连续对照期内使用 BZD 的情况。我们使用条件逻辑回归来调整伴随药物,以确定在发生 AACG 的患者中,病例期与对照期相比使用 BZD 的比值比。
在 11093 例新诊断为 AACG 的患者中,有 6709 例在诊断前开具了 BZD 处方。BZD 使用与 AACG 风险增加相关(调整后的比值比[aOR] = 1.40;95%置信区间[CI] 1.27-1.54)。短效(aOR = 1.40,95% CI 1.24-1.57)和长效 BZD(aOR = 1.33,95% CI 1.18-1.50)的 AACG 风险相似。
我们发现 BZD 使用与韩国人群的 AACG 风险相关。临床医生应仔细监测 BZD 治疗患者视力障碍的发生情况。