The relationship between 5α-reductase inhibitors and the presence of following open angle glaucoma: a TriNetX cohort...

This study was conducted to test a possible association between 5α-reductase inhibitor (5ARI) use and subsequent open-angle glaucoma (OAG).

A retrospective cohort study was conducted, and individuals with benign prostate hyperplasia (BPH) and androgenetic alopecia were included and classified according to whether they received 5ARI treatment. A total of 181,208 individuals were included in each of the 5ARI and non-5ARI groups. The primary outcome was the development of OAG according to diagnostic and procedure codes. Cox proportional hazard regression was performed for the statistical analysis.

OAG occurred in 3477 patients (5.14%) in the 5ARI group and 3044 patients (4.59%) in the non-5ARI group. After adjustment for multiple covariates, exposure to 5ARIs was associated with a significantly greater risk of OAG compared with the non-5ARI treatment (P < 0.001). The cumulative incidence of OAG was significantly higher among patients receiving 5ARI therapy than among those in the non-5ARI group (P < 0.001), and the cumulative incidence of HTG was significantly higher in the 5ARI population than the non-5ARI population (P = 0.002). In the sensitivity analysis, the 5ARI cohort exhibited significantly increased rates of OAG and HTG compared with the non-5ARI cohort, except for Asian individuals (P > 0.05).

The use of 5ARIs may be related to the development of OAG.