Department of Clinical Pharmacy, Nihon University School of Pharmacy, Chiba, Japan.
Nihon University Itabashi Hospital Clinical Research Center, Tokyo, Japan.
PLoS One. 2020 Aug 17;15(8):e0237617. doi: 10.1371/journal.pone.0237617. eCollection 2020.
Some findings on the association between glaucoma and statins in the Asian population have been reported. We conducted a retrospective cohort study using health insurance claims data maintained by the JMDC Inc., which comprises data on about three million individuals representing 2.4% of the Japanese population. The association between the potency of statins and open-angle glaucoma in Japanese working-age population was examined using a commercially available health insurance claims and enrollment database. We identified 117,036 patients with a prescription of statins between January 1, 2005 and March 31, 2014; 59,535 patients were selected as new statin users. Of these, 49,671 (83%) patients without glaucoma who were prescribed statins for the first time were part of the primary analysis. New users of statin were defined as those with a prescription of statin at the beginning of the study, but without a prescription six months earlier. The cohort comprised 29,435 (59%) and 20,236 (41%) patients with a prescription of high-potency statin (atorvastatin and rosuvastatin) and low-potency statin (pravastatin, fluvastatin, pitavastatin, and simvastatin), respectively. Using Cox proportional hazards regression analysis, hazard ratios (HRs) were estimated for glaucoma adjusted for baseline characteristics. Although some baseline characteristics were not similar between the high-potency and low-potency statin groups, the standardized difference for all covariates was less than 0.1. No associations were found between high-potency statin use and glaucoma (adjusted HR = 1.08; 95% confidence interval, 0.93-1.24) in the primary analyses, using the risk for glaucoma in the low-potency statin group as reference. The risk of glaucoma with individual statin use was not significantly different from that with pravastatin. No significant association was found between high-potency statins and the increased risk of glaucoma in Japanese working-age population. Further studies are needed to examine the association between statins and glaucoma in the elderly population.
一些关于亚洲人群中青光眼和他汀类药物之间关联的研究结果已经报道。我们使用 JMDC Inc. 维护的健康保险索赔数据进行了回顾性队列研究，该数据涵盖了约 300 万人，占日本人口的 2.4%。使用商业可用的健康保险索赔和登记数据库，研究了日本工作年龄人群中他汀类药物的效力与开角型青光眼之间的关联。我们确定了 117036 名在 2005 年 1 月 1 日至 2014 年 3 月 31 日期间服用他汀类药物的患者；选择了 59535 名新的他汀类药物使用者。其中，49671 名（83%）首次服用他汀类药物且无青光眼的患者被纳入主要分析。新的他汀类药物使用者被定义为在研究开始时开具他汀类药物处方，但在六个月前没有处方的患者。该队列包括 29435 名（59%）和 20236 名（41%）患者，他们分别服用高效力他汀类药物（阿托伐他汀和瑞舒伐他汀）和低效力他汀类药物（普伐他汀、氟伐他汀、匹伐他汀和辛伐他汀）。使用 Cox 比例风险回归分析，根据基线特征调整了青光眼的风险比（HR）。尽管高效力和低效力他汀类药物组之间的一些基线特征不完全相似，但所有协变量的标准化差异均小于 0.1。在主要分析中，以低效力他汀类药物组的青光眼风险为参考，发现高效力他汀类药物使用与青光眼之间没有关联（调整后的 HR = 1.08；95%置信区间，0.93-1.24）。单独使用他汀类药物治疗的青光眼风险与普伐他汀无显著差异。在日本工作年龄人群中，高效力他汀类药物与青光眼风险增加之间未发现显著关联。需要进一步研究来检查他汀类药物与老年人群中青光眼之间的关联。
