Using Healthcare Databases to Refine Understanding of Exploratory Associations Between Drugs and Progression of...

Area of Science:

• Ophthalmology
• Pharmacology
• Public Health

Background:

• Prior studies suggested associations between certain medications and open-angle glaucoma (OAG) progression.
• Understanding these drug effects is crucial for managing OAG and preventing advanced disease requiring surgery.

Purpose of the Study:

• To investigate the association between specific drug classes and the progression to glaucoma filtration surgery in patients with OAG.
• To refine understanding of potential links between angiotensin-II receptor blockers, metformin, SSRIs, fibric-acid derivatives, or CCBs and OAG surgical progression.

Main Methods:

• Employed new-initiator, active-comparator cohort designs across two distinct data sources.
• Utilized stabilized inverse-probability-of-treatment weights for confounder adjustment.
• Evaluated outcomes using both "intention-to-treat" and "as-treated" follow-up analyses.

Main Results:

• Kaplan-Meier curves indicated a trend towards more rapid progression to glaucoma filtration surgery in patients taking calcium channel blockers (CCBs) compared to thiazides.
• This trend was observed in both "as-treated" and "intention-to-treat" analyses across both data sources, with statistical significance in some instances.
• A potential delayed progression was suggested for selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants in one dataset, but this was not consistently observed.

Conclusions:

• The study provides evidence supporting a relationship between calcium channel blockers and the progression of open-angle glaucoma.
• No significant association was found between other investigated drug classes (ARBs, metformin, SSRIs, fibric-acid derivatives) and OAG progression to filtration surgery.