0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation | Clinical Sciences

Association of Statin Use With Cataracts:  A Propensity Score–Matched Analysis

Jessica Leuschen, MD1,2; Eric M. Mortensen, MD, MSc3,4; Christopher R. Frei, PharmD, MS5,6; Eva A. Mansi, FRCS8; Vasudha Panday, MD1,2,7; Ishak Mansi, MD3,4
[+] Author Affiliations
1Wilford Hall Ambulatory Surgery Center, San Antonio, Texas
2San Antonio Military Medical Center, San Antonio, Texas
3VA North Texas Health Care System, Dallas, Texas
4University of Texas Southwestern Medical Center, Dallas
5College of Pharmacy, The University of Texas at Austin
6Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center, San Antonio, Texas
7Uniformed Services University of the Health Sciences, University of Texas Health Science Center, San Antonio, Texas
8Ramad Hospital, Alexandria, Egypt
JAMA Ophthalmol. 2013;131(11):1427-1434. doi:10.1001/jamaophthalmol.2013.4575.
Text Size: A A A
Published online

Importance  Cataracts are a main cause of low vision; with the growing elderly population, the incidence of cataracts is likely to increase. Investigators have previously hypothesized that statin antioxidant effects may slow the natural aging process of the lens.

Objective  To compare the risks for development of cataracts between statin users and nonusers.

Design  A propensity score–matched cohort analysis using retrospective data from October 1, 2003, to March 1, 2010. A propensity score–matched cohort of statin users and nonusers was created using 44 variables.

Setting  Database of a military health care system.

Participants  Based on medication fills during fiscal year 2005, patients were divided into 2 groups: (1) statin users (received at least a 90-day supply of statin) and (2) nonusers (never received a statin throughout the study). Among 46 249 patients meeting study criteria, we identified 13 626 statin users and 32 623 nonusers.

Exposure  Use of statin therapy for more than 90 days.

Main Outcomes and Measures  Primary analysis examined the risks for cataract in the propensity score–matched cohort. Secondary analyses examined the risks for cataract in patients with no comorbidities according to the Charlson Comorbidity Index (patients with no Charlson comorbidity). A sensitivity analysis was conducted to repeat the secondary analysis in patients taking statins for durations of 2, 4, and 6 years.

Results  For our primary analysis, we matched 6972 pairs of statin users and nonusers. The risk for cataract was higher among statin users in comparison with nonusers in the propensity score–matched cohort (odds ratio, 1.09; 95% CI, 1.02-1.17). In secondary analyses, after adjusting for identified confounders, the incidence of cataract was higher in statin users in comparison with nonusers (odds ratio, 1.27; 95% CI, 1.15-1.40). Sensitivity analysis confirmed this relationship.

Conclusions and Relevance  The risk for cataract is increased among statin users as compared with nonusers. The risk-benefit ratio of statin use, specifically for primary prevention, should be carefully weighed, and further studies are warranted.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 11

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Scenario

Users' Guides to the Medical Literature
Statin Dosing and LDL Levels

brightcove.createExperiences();