Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, CH-4031, Basel, Switzerland.
Eur J Clin Pharmacol. 2020 Sep;76(9):1329-1335. doi: 10.1007/s00228-020-02923-y. Epub 2020 Jun 6.
Three previous studies reported controversial results regarding selective serotonin reuptake inhibitor (SSRI) exposure and cataract development. We therefore aimed to assess risk of cataract associated with previous exposure to SSRI using data from a large health insurance in Switzerland.
In a case-control study, we analyzed individuals insured by the Helsana Group, a large Swiss health insurance provider. We matched patients aged 40 years or older with cataract extraction (i.e., a proxy for a cataract diagnosis) in 2014 or 2015 to four control patients, on age, sex, date of cataract extraction, and area of residence. Exposure of interest was the number of SSRI claims prior to cataract extraction. We conducted conditional logistic regression analyses to calculate odds ratios (OR) with 95% confidence intervals (CI). We adjusted our analyses for the presence of hypertension, diabetes, glaucoma, systemic steroid use, and use of other antidepressant drugs.
We identified 13,773 cataract cases and 51,625 matched controls. Compared with non-use, long-term use of SSRI (≥ 20 claims) was not associated with an altered risk of cataract (adjusted OR 0.93, 95% CI 0.84-1.04). The analysis of the individual drug substances also yielded no statistically significant association between drug exposure and the risk of cataract.
According to our study, use of SSRI does not change the risk of cataract in the overall population.
此前有三项研究报告了关于选择性 5-羟色胺再摄取抑制剂(SSRIs)暴露与白内障发展之间的结果存在争议。因此,我们旨在使用瑞士一家大型医疗保险的数据评估先前接触 SSRIs 与白内障相关的风险。
在一项病例对照研究中,我们分析了瑞士大型医疗保险提供商 Helsana 集团的参保人员。我们将在 2014 年或 2015 年接受白内障手术(即白内障诊断的替代指标)的年龄在 40 岁及以上的患者与 4 名对照患者进行匹配,匹配因素包括年龄、性别、白内障手术日期和居住地区。感兴趣的暴露因素是白内障手术前 SSRI 药物的使用次数。我们进行了条件逻辑回归分析,以计算比值比(OR)及其 95%置信区间(CI)。我们调整了分析结果,以考虑到高血压、糖尿病、青光眼、全身类固醇使用以及其他抗抑郁药物的使用情况。
我们确定了 13773 例白内障病例和 51625 例匹配对照。与非使用者相比,长期使用 SSRIs(≥20 次)与白内障风险无显著变化(调整后的 OR 0.93,95%CI 0.84-1.04)。对个别药物物质的分析也没有显示药物暴露与白内障风险之间存在统计学显著关联。
根据我们的研究,SSRIs 的使用不会改变总体人群患白内障的风险。