دورية أكاديمية
Erythropoiesis-Stimulating Agents and the Risk of Vision-Threatening Diabetic Retinopathy.
| العنوان: | Erythropoiesis-Stimulating Agents and the Risk of Vision-Threatening Diabetic Retinopathy. |
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| المؤلفون: | Tsui JC; Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA., Willett K; Kittner Eye Center, Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, USA., Cohen JB; Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania. Philadelphia, Philadelphia, Pennsylvania, USA., Yu Y; Center for Preventative Ophthalmology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA., VanderBeek BL; Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.; Center for Pharmacoepidemiology Research and Training, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.; Leonard Davis Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. |
| المصدر: | Ophthalmic epidemiology [Ophthalmic Epidemiol] 2024 Jun; Vol. 31 (3), pp. 249-257. Date of Electronic Publication: 2023 Jul 10. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Informa Healthcare Country of Publication: England NLM ID: 9435674 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-5086 (Electronic) Linking ISSN: 09286586 NLM ISO Abbreviation: Ophthalmic Epidemiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : Informa Healthcare Original Publication: Buren, The Netherlands : Aeolus Press, c1994- |
| مواضيع طبية MeSH: | Diabetic Retinopathy*/epidemiology , Diabetic Retinopathy*/drug therapy , Diabetic Retinopathy*/diagnosis , Hematinics*/adverse effects , Hematinics*/administration & dosage , Hematinics*/therapeutic use, Humans ; Male ; Retrospective Studies ; Female ; Aged ; Middle Aged ; Incidence ; Macular Edema/drug therapy ; Macular Edema/epidemiology ; Macular Edema/etiology ; Risk Factors ; United States/epidemiology ; Aged, 80 and over |
| مستخلص: | Purpose: Animal studies have suggested that Erythropoiesis-Stimulating Agents (ESAs) may increase vascular endothelial growth factor (VEGF)-related retinopathies, but this effect is unclear in humans. This study evaluates the risk of vision-threatening diabetic retinopathy (VTDR), defined as either diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR), in patients exposed to an ESA. Methods: Two analyses were performed. First, a retrospective matched-cohort study was designed using a de-identified commercial and Medicare Advantage medical claims database. The ESA cohort of non-proliferative diabetic retinopathy patients who were new users of an ESA from 2000 to 2022 was matched to controls up to a 3:1 ratio. Exclusion criteria included less than 2 years in the plan, history of VTDR or history of other retinopathy. Multivariable Cox proportional hazards regression with inverse proportional treatment weighting (IPTW) was used to assess the hazard of developing VTDR, DME, and PDR. The second analysis was a self-controlled case series (SCCS) evaluating the incidence rate ratios (IRR) of VTDR during 30-day periods before and after initiating an ESA. Results: After inclusion of 1502 ESA-exposed patients compared with 2656 controls, IPTW-adjusted hazard ratios found the ESA cohort had an increased hazard of progressing to VTDR (HR = 3.0 95%CI:2.3-3.8; p < .001) and DME (HR = 3.4,95%CI:2.6-4.4, p < .001), but not PDR (HR = 1.0,95%CI:0.5-2.3, p = .95). Similar results were found within the SCCS which demonstrated higher IRRs for VTDR (IRRs = 1.09-1.18; p < .001) and DME (IRRs = 1.16-1.18; p < .001), but not increased IRRs in PDR (IRR = 0.92-0.97, p = .02-0.39). Conclusion: ESAs are associated with higher risks for VTDR and DME, but not PDR. Those studying ESAs as adjunctive therapy for DR should be cautious of possible unintended effects. |
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| معلومات مُعتمدة: | K23 EY025729 United States EY NEI NIH HHS; P30 EY001583 United States EY NEI NIH HHS |
| فهرسة مساهمة: | Keywords: Diabetic macular edema; Erythropoiesis-Stimulating Agents; Vision threatening diabetic retinopathy; proliferative diabetic retinopathy |
| المشرفين على المادة: | 0 (Hematinics) |
| تواريخ الأحداث: | Date Created: 20230710 Date Completed: 20240508 Latest Revision: 20240510 |
| رمز التحديث: | 20240510 |
| مُعرف محوري في PubMed: | PMC10776797 |
| DOI: | 10.1080/09286586.2023.2235001 |
| PMID: | 37427852 |
| قاعدة البيانات: | MEDLINE |
PDF full text from Publisher | تدمد: | 1744-5086 |
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| DOI: | 10.1080/09286586.2023.2235001 |