AgingResearch.NewsJoin free
BMJ Open Ophthalmology

Long-term proton-pump inhibitor use linked to eye disease

Macular degeneration developed in 1.64% of users versus 1.34% of unexposed adults over a median 3.8 years of follow-up.

Paper by Maria Anna Bantounou, Maria Emfietzoglou, Konstantinos G Baroutis, 2 more authorsDemetrios G. Vavvas · Massachusetts Eye and Ear Infirmary
Figure 1. Cumulative incidence of AMD and death over 10 years after the landmark date among sustained PPI exposed participants and matched unexposed controls.
Open the figure at full size
Figure 1. Cumulative incidence of AMD and death over 10 years after the landmark date among sustained PPI exposed participants and matched unexposed controls.Cumulative incidence of AMD and death over 10 years after the landmark date among sustained PPI exposed participants and matched unexposed controls.Bantounou et al.
Cohort study of adults aged ≥60 years, median 3.8 years, against unexposed controlsPopulations

49,796 participants, 10 years

Limit: Family history of AMD and genetic susceptibility were incompletely captured and could distort the association

Edited by Boris Djordjevic · AgingResearch.News

Paper
Follow

In adults aged 60 or older, researchers compared 49,796 proton-pump inhibitor users with 49,796 matched unexposed controls in a retrospective observational cohort study. These drugs reduce stomach acid. Participants had a median age of 66, and 56% were female. Users had accumulated at least two years of use within three years.

Using hospital records, researchers tracked new diagnoses of age-related macular degeneration, an eye disease affecting central vision, for up to 10 years. Over a median 3.8 years, diagnoses occurred in 1.64% of users and 1.34% of controls. Analyses accounting for death linked sustained use to a modestly higher risk. The association also appeared when researchers compared users with people taking a different class of acid-reducing drugs. That other drug class was not associated with macular degeneration when compared with unexposed controls.

Why it matters

For older adults, the study addressed whether sustained medication exposure is linked to an age-related eye disease. The authors called for further investigation to determine the association’s clinical implications.

Caveats

This observational study could not establish causation, and matching may not remove all differences between groups. The findings concern adults aged 60 or older, nearly 90% of whom were White, rather than younger or more diverse populations.

From the paper

Participants

We included 49 796 PPI exposed participants and 49 796 matched controls.

Results

Follow-up

Over a median follow-up of 3.8 years (IQR, 1.5–7.1 years), 814/49 796 PPI exposed participants (1.64%) developed AMD, versus 668/49 796 controls (1.34%).

Results, PPI exposure versus unexposed matched controls

Result

The incidence rate was 3.70 versus 3.03 per 1000 person-years, respectively (overall sHR=1.24, 95% CI 1.12 to 1.38, p<0.001; HR=1.25, 95% CI 1.13 to 1.38; p<0.001).

Results, PPI exposure versus unexposed matched controls

Events by group

Over a median follow-up of 3.8 years (IQR, 1.5–7.1 years), 814/49 796 PPI exposed participants (1.64%) developed AMD, versus 668/49 796 controls (1.34%).

Results, PPI exposure versus unexposed matched controls

Limitation

First, the retrospective design introduces the possibility of residual confounding.

Discussion

Quoted word for word from the full text on PubMed Central.

Comments

Be the first to comment.

More on Age-related macular degeneration