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Pulmonary safety of ophthalmic beta‐blockers: a nationwide registry‐based cohort study
Author(s) -
Kristensen Mathias L.,
Simonsen Jan H.,
TorpPedersen Christian,
Vorum Henrik,
Aasbjerg Kristian
Publication year - 2018
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13663
Subject(s) - medicine , concomitant , odds ratio , confidence interval , cohort , cohort study , population , surgery , environmental health
Abstract Purpose Ophthalmic beta‐blockers, used in the treatment of increased intraocular pressure, are known to cause pulmonary adverse effects. Few, if any, studies have quantified the extent of the problem in a real‐life population. In this nationwide study, we assess the pulmonary safety of patients initiating treatment with ophthalmic beta‐blockers. Methods Using the Danish Nationwide Registries from 1995 to 2012, we identified all individuals aged 20–90 years who initiated monotherapy with an intraocular pressure‐lowering drug, with or without concomitant obstructive pulmonary disease. Risks of (i) switching to another drug and (ii) new onset of obstructive pulmonary disease during a 90‐day follow‐up were examined by cumulative risk and logistic regression models adjusted for available covariates. Results The cohort consisted of 97 463 individuals. Odds ratios for drug switch in individuals without concomitant obstructive pulmonary disease ( n = 86 568) were as follows: 1.47 for beta‐blockers (95% confidence interval ( CI ): 1.35–1.61; p < 0.001), 2.68 for parasympathomimetics (95% CI : 2.32–3.10; p < 0.001) and 4.80 for alfa‐2‐agonists (95% CI : 4.17–5.53; p < 0.001). Odds ratios in individuals with concomitant obstructive pulmonary disease ( n = 10 895) were as follows: 2.61 for parasympathomimetics (95% CI : 1.83–3.72; p < 0.001), 2.96 for beta‐blockers (95% CI : 2.31–3.78; p < 0.001) and 3.54 for alfa‐2‐agonists (95% CI : 2.56–4.88; p < 0.001). There was no significant association between treatment class and new onset of obstructive pulmonary disease (p = 0.30). Conclusion Ophthalmic beta‐blockers were associated with an increased risk of drug switch. However, the absolute risk was very small. No increased risk of new onset of obstructive pulmonary disease was found. Our data suggest that more patients might be eligible for ophthalmic beta‐blockers.