Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California.
Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
Retina. 2023 Nov 1;43(11):1914-1921. doi: 10.1097/IAE.0000000000003870.
This study was conducted to evaluate the association of oral montelukast, selective antagonism for cysteinyl leukotriene receptor 1, with reduced odds of exudative age-related macular degeneration (exAMD) development.
This case-control study was conducted using institutional cohort finder tool, and included 1913 patients with exAMD (ICD: H35.32 and 362.52) and 1913 age- and gender-matched control subjects without exAMD. Subanalysis among 1913 exAMD and 324 nonexudative AMD was also conducted.
A total of 47 (2.5%) exAMD cases were identified to have a history of oral montelukast use before exAMD diagnosis, compared with 84 (4.4%) controls. Montelukast usage was significantly associated with reduced odds of exAMD in the multivariable analysis (adjusted odds ratio [OR]: 0.50, 95% confidence interval: 0.31-0.80) and nonsteroidal anti-inflammatory drug usage (adjusted OR: 0.69). Caucasian race, history of smoking, and nonexudative macular degeneration in either eye were also found to have a significant relationship with increased odds of exAMD. In the subanalysis, montelukast usage showed significant association with reduced odds of developing exAMD from nonexudative AMD (adjusted OR: 0.53, 95% confidence interval: 0.29-0.97) and the presence of atopic disease (adjusted OR: 0.60).
The study results suggested that oral montelukast is linked to reduced odds of exAMD development.
本研究旨在评估口服孟鲁司特(选择性半胱氨酰白三烯受体 1 拮抗剂)与减少渗出性年龄相关性黄斑变性(exAMD)发展的可能性之间的关联。
本病例对照研究使用机构队列发现工具进行,共纳入 1913 例 exAMD(ICD:H35.32 和 362.52)患者和 1913 名年龄和性别匹配的无 exAMD 对照患者。还对 1913 例 exAMD 和 324 例非渗出性 AMD 进行了亚组分析。
共发现 47 例(2.5%)exAMD 病例在 exAMD 诊断前有口服孟鲁司特使用史,而对照组为 84 例(4.4%)。多变量分析显示,孟鲁司特的使用与 exAMD 的可能性降低显著相关(调整后的优势比[OR]:0.50,95%置信区间:0.31-0.80)和非甾体抗炎药的使用(调整后的 OR:0.69)。白种人、吸烟史和双眼存在非渗出性黄斑变性也被发现与 exAMD 的可能性增加显著相关。在亚组分析中,孟鲁司特的使用与从非渗出性 AMD 发展为 exAMD 的可能性降低显著相关(调整后的 OR:0.53,95%置信区间:0.29-0.97)和特应性疾病的存在(调整后的 OR:0.60)。
研究结果表明,口服孟鲁司特与降低 exAMD 发展的可能性有关。