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Association Between PCSK9 Inhibitor Use and Risk of Age-Related Macular Degeneration.
Chien-Yun Tsai1,2, Chien-Hsiang Weng3,4, Ching-Yao Tsai5,6,7
1School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Translational Vision Science & Technology
|May 29, 2026
Summary
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were linked to a reduced risk of age-related macular degeneration (AMD) compared to statin therapy in a large real-world study. Further research is recommended to confirm these findings for AMD prevention.
Area of Science:
- Ophthalmology
- Cardiology
- Pharmacology
Background:
- Age-related macular degeneration (AMD) is associated with systemic lipid imbalance, vascular dysfunction, and inflammation.
- The impact of novel lipid-lowering agents, PCSK9 inhibitors, on ocular health, specifically AMD risk, remains largely unestablished.
- Statins are a common treatment for hyperlipidemia, but their effect on AMD risk is not fully understood.
Purpose of the Study:
- To evaluate the association between proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor use and the risk of developing age-related macular degeneration (AMD).
- To compare the risk of AMD in patients treated with PCSK9 inhibitors versus those treated with statin therapy.
- To investigate the potential of PCSK9 inhibition as a strategy for modifying AMD risk.
Main Methods:
- A retrospective, propensity score-matched cohort study was conducted using the TriNetX electronic health record database (2015-2024).
- Adults aged 50 years or older with hyperlipidemia and no prior retinal disease were included and matched 1:1 based on various clinical and demographic variables.
- Cox proportional hazards models and Kaplan-Meier analyses were used to assess AMD incidence and compare risks between PCSK9 inhibitor and statin therapy groups.
Main Results:
- Among 56,660 matched participants, PCSK9 inhibitor use was associated with a significantly lower risk of AMD compared to statin therapy (HR, 0.82; 95% CI, 0.73-0.90).
- This association remained consistent across different follow-up intervals and in various subgroups, including different age groups, males, individuals without type 2 diabetes, nonobese individuals, and those with shorter durations of hyperlipidemia.
- Sensitivity and stratified analyses supported the robustness of the findings.
Conclusions:
- PCSK9 inhibitor use is associated with a reduced risk of age-related macular degeneration (AMD) when compared to statin monotherapy in a real-world setting.
- These findings suggest that PCSK9 inhibition may represent a potential therapeutic strategy for mitigating AMD risk.
- Further prospective studies are warranted to establish causality and elucidate the underlying mechanisms.
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