Statin Use and OAG
In the following retrospective, longitudinal cohort analysis, researchers sought to determine whether 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) affect the risk of developing open-angle (OAG) in persons
They included in their study individuals aged ≥60 years with hyperlipidemia enrolled in a national United States managed care network
between 2001 and 2009. They performed Multivariable Cox regression analyses to assess the relationship between statin use and the development
of OAG (from no prior OAG diagnosis), progression from a prior diagnosis of glaucoma suspect to a diagnosis of OAG, and need for medical or
operative interventions for OAG. The researchers also adjusted regression models for sociodemographic factors and medical and ocular
comorbidities. Main outcome measures were hazard ratios (HRs) with 95% confidence intervals (CIs).
Of the 524,109 individuals with hyperlipidemia, 316,182 (60%) had ≥1 outpatient prescription for statins, the researchers noted.
They found that the hazard of developing OAG decreased 0.3% (adjusted HR, 0.997; 95% CI 0.994–0.999) for every additional month
of statin consumption. They also reported that individuals with hyperlipidemia who took statins continuously for 2 years had an 8%
(adjusted HR, 0.922; 95% CI, 0.870–0.976) decreased OAG risk relative to those who received no statin therapy. Additionally the study
researchers observed that the hazard of progressing from a diagnosis of glaucoma suspect to OAG decreased 0.4% (adjusted HR, 0.996; 95%
CI, 0.993–0.999) for every 2 years and had a 9% (adjusted HR, 0.907; 95% CI, 0.846–0.973) decreased risk of progressing from
glaucoma suspect to OAG relative to those who received no statin therapy. The hazard of requiring medical treatment for OAG decreased 0.4%
(adjusted HR, 0.996; 95% CI, 0.993–0.998) for every additional month of statin exposure. The researchers noted no differences in need
for glaucoma surgery among those with OAG who were and were not taking stains (adjusted HR, 1.002; 95% CI, 0.994–1.010).
Statin use was associated with a significant reduction in the risk of OAG among persons with hyperlipidemia. Given the mounting evidence of
statin protection against OAG including both basic science and observational clinical studies, an interventional prospective study might
provide additional insights into the role of statins in the prevention of early OAG.