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Published on: March 12, 2016
Use of topiramate and risk of glaucoma: a case-control study
Mahyar Etminan1, David Maberley, Frederick S Mikelberg
1Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Canada. mahyar.etminan@vch.ca
Purpose:
To examine the possible link of acute-onset glaucoma with topiramate.
Design:
Case-control study.
Methods:
A case-control study was conducted among a cohort of subjects who had visited an ophthalmologist in the Province of British Columbia, Canada from 2000 to 2007. Cases were identified as those newly diagnosed with glaucoma (ICD-9 360). For each case, 5 controls were selected and matched to the cases by age and calendar time using density-based sampling. Crude and adjusted rate ratios (RRs) for current and past use of topiramate were computed. As a sensitivity analysis, the risk of glaucoma with a positive control drug (an oral steroid) and a negative control drug (inhaled albuterol) was also assessed.
Results:
From the initial cohort of 989 591 subjects, 178 264 cases of glaucoma and 891 320 controls were identified. There was a slight increase in the risk of glaucoma among current users of topiramate (RR = 1.23 [95% confidence interval (CI), 1.09-1.40]). This risk was further elevated among new users of the drug (RR = 1.54 [95% CI, 1.09-2.17]). No increase in the risk of glaucoma requiring drug therapy was observed among current topiramate users (RR = 1.09 [95% CI, 0.80-1.61]).
Conclusion:
We found an increase in the risk of glaucoma with first-time users of topiramate. Future studies are needed to confirm these findings.
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