当前使用静止剂与发生的与年龄相关的黄斑变性病的关联:使用时间变化的倾向得分
Blondy Kayembe-Mulumba1, Karen Leffondré2, Petra P Larsen2
1Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, F-33000, France. blondy.kayembe-mulumba@u-bordeaux.fr.
概括
目前使用他类药物似乎不会增加老年人中等或高级年龄相关黄斑变性 (AMD) 的风险. 这项研究使用了先进的统计方法来控制ALIENOR队列中的混因素.
科学领域:
- 眼科医生 眼科 眼科
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
背景情况:
- 类他类药物具有可能影响与年龄相关的黄斑变性 (AMD) 的性作用.
- 之前关于他类药物和AMD风险的研究已经产生了有争议的结果,可能是由于根据指示混.
- 老年人,通常有高心血管风险,是他类药物的主要使用者.
研究的目的:
- 调查当前使用他类药物与中级和高级AMD发病率之间的关联.
- 为了解决使用基于时间变化倾向得分的治疗权重反向概率 (IPTW) 的指示混问题.
主要方法:
- 对73岁以上的成年人基于人口的前性ALIENOR队列 (n=963) 的分析,从2006年到2020年进行跟踪.
- 通过问卷来评估他类药物的使用,并通过多模式视网膜成像来确定AMD状态.
- 使用IPTW的时间依赖的Cox比例危险模型来估计发生的AMD的调整危险比率 (aHR).
主要成果:
- 在7年的中位随访期间,中级AMD的累积发病率为36%,高级AMD为10%.
- 在控制混杂后,当前使用他类药物与中期 (aHR: 1.02 [0.72-1.45]) 或晚期AMD (aHR: 1.08 [0.61-1.91]) 的风险增加无关.
- 对他类药物亚型和所有降脂剂的分析也显示了与AMD风险的非显著关联.
结论:
- 在老年人中,他类药物似乎没有显著影响中期或晚期AMD发展的风险.
- 这些发现仍然存在,尽管他类药物影响AMD进展的生物学可信性.
- 该研究强调了在涉及他类药物的观察性研究中通过指示控制混的重要性.
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