Association of Drugs With Acute Angle Closure.
AI Summary
This study identified 61 drugs, including sumatriptan, topiramate, and duloxetine, associated with acute angle-closure glaucoma, highlighting the need for clinicians to consider this risk.
Abstract
Importance
Acute angle-closure (AAC) glaucoma is a sight-threatening disease and can reportedly occur in association with various drugs.
Objective
To identify drugs that are associated with AAC glaucoma occurrence and evaluate the risk of AAC associated with each drug.
Design, setting, and participants: A case-crossover study was conducted using the Health Insurance Review and Assessment Service database, which contains medical information of the entire Korean population. Patients who were first diagnosed with AAC and treated between 2013 and 2019 were identified using diagnostic and procedure codes. All drugs that the study participants were prescribed as well as prescription dates during the period of 1 to 180 days before the onset of AAC were extracted from the database. For each patient, 1 to 30 days before onset was considered the hazard period, and 91 to 180 days before AAC onset was considered the control period.
Main outcomes and measures: Drugs associated with AAC and odds (calculated as odds ratios [ORs] with 95% CIs) of AAC development associated with each identified drug.
Results
A total of 949 drugs that were prescribed to 13 531 patients with AAC (mean [SD] age, 66.8 [10.6] years; 9585 [70.8%] female) during the period of 1 to 180 days before the onset of AAC were analyzed. A total of 61 drugs were found to be associated with AAC, among which sumatriptan (OR, 12.60 [95% CI, 4.13-38.44]) was associated with the highest odds of AAC development, followed by topiramate (OR, 5.10 [95% CI, 2.22-11.70]) and duloxetine (OR, 4.04 [95% CI, 2.95-5.54]). The median (IQR) period from prescription of the drug to the onset of AAC for the 61 drugs was 11.9 days (10.9-12.8). A number of drugs not previously considered to be associated with AAC, including lactulose (OR, 2.81 [95% CI, 1.72-4.61]) and metoclopramide (OR, 2.52 [95% CI, 1.95-3.25]), were identified.
Conclusions and relevance: Results of this case-crossover study suggest a need to consider AAC risk in patients taking any of the 61 drugs found to be associated with AAC.
MeSH Terms
Shields Classification
Key Concepts6
A case-crossover study using the Health Insurance Review and Assessment Service database identified 61 drugs associated with acute angle-closure (AAC) glaucoma in 13,531 patients.
Sumatriptan was associated with the highest odds of acute angle-closure (AAC) development (OR, 12.60 [95% CI, 4.13-38.44]) among 61 identified drugs in a case-crossover study of 13,531 patients.
Topiramate was associated with increased odds of acute angle-closure (AAC) development (OR, 5.10 [95% CI, 2.22-11.70]) in a case-crossover study of 13,531 patients.
Duloxetine was associated with increased odds of acute angle-closure (AAC) development (OR, 4.04 [95% CI, 2.95-5.54]) in a case-crossover study of 13,531 patients.
Lactulose (OR, 2.81 [95% CI, 1.72-4.61]) and metoclopramide (OR, 2.52 [95% CI, 1.95-3.25]) were identified as drugs associated with acute angle-closure (AAC) in a case-crossover study of 13,531 patients, despite not being previously considered AAC-associated.
The median period from drug prescription to the onset of acute angle-closure (AAC) for the 61 identified drugs was 11.9 days (IQR, 10.9-12.8) in a case-crossover study of 13,531 patients.
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