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Oral bisphosphonate use and age-related macular degeneration: retrospective cohort and nested case-control study

Oral bisphosphonate use and age-related macular degeneration: retrospective cohort and nested case-control study
Oral bisphosphonate use and age-related macular degeneration: retrospective cohort and nested case-control study
Our objective here was to determine whether oral bisphosphonate (BP) use is associated with the incidence of age-related macular degeneration (AMD). We performed a population-based study using electronic health records from UK primary care (Clinical Practice Research Datalink). A cohort of 13,974 hip fracture patients (1999–2013) was used to conduct (1) a propensity score–matched cohort analysis and (2) a nested case–control analysis. Hip fracture patients were aged ≥50 years without AMD diagnosis before hip fracture date or in the first year of follow-up. Among 6208 matched patients and during 22,142 person-years of follow-up, 57 (1.8%) and 42 (1.4%) AMD cases occurred in BP users and non-BP users, respectively. The survival analysis model did not provide significant evidence of a higher risk of AMD in BP users (subhazard ratio: 1.60; 95% confidence interval (CI): 0.95–2.72; P = 0.08), although there was a significant increased risk among BP users with high medication possession ratio (MPR) (top quartile) relative to non-BP users (odds ratio: 5.08, 95% CI: 3.11–8.30; P < 0.001, respectively). Overall, oral BP use was not associated with an increased risk of AMD in this cohort of hip fracture patients, although the risk increased significantly with higher MPR. More data are needed to confirm these findings.
0077-8923
1-13
Garriga, C.
5403565c-65fd-448f-904f-e41df634c888
Pazianas, Michael
dcba1270-21c4-4b16-b0ca-4ec9ad12eecc
Hawley, Samuel
407712ed-30ba-4458-a0f3-f6278e219845
Delmestri, A.
c1dfbd4f-1ec0-4e02-a6fa-423f90edc322
Prieto-Alhambra, D
051113cd-2da1-4e0d-aa4b-d7b1fe63cd12
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Judge, Andrew
b853f89f-dc44-428e-9fe2-35e925544abe
Garriga, C.
5403565c-65fd-448f-904f-e41df634c888
Pazianas, Michael
dcba1270-21c4-4b16-b0ca-4ec9ad12eecc
Hawley, Samuel
407712ed-30ba-4458-a0f3-f6278e219845
Delmestri, A.
c1dfbd4f-1ec0-4e02-a6fa-423f90edc322
Prieto-Alhambra, D
051113cd-2da1-4e0d-aa4b-d7b1fe63cd12
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Judge, Andrew
b853f89f-dc44-428e-9fe2-35e925544abe

Garriga, C., Pazianas, Michael, Hawley, Samuel, Delmestri, A., Prieto-Alhambra, D, Cooper, Cyrus and Judge, Andrew (2018) Oral bisphosphonate use and age-related macular degeneration: retrospective cohort and nested case-control study. Annals of the New York Academy of Sciences, 1-13. (doi:10.1111/nyas.13589).

Record type: Article

Abstract

Our objective here was to determine whether oral bisphosphonate (BP) use is associated with the incidence of age-related macular degeneration (AMD). We performed a population-based study using electronic health records from UK primary care (Clinical Practice Research Datalink). A cohort of 13,974 hip fracture patients (1999–2013) was used to conduct (1) a propensity score–matched cohort analysis and (2) a nested case–control analysis. Hip fracture patients were aged ≥50 years without AMD diagnosis before hip fracture date or in the first year of follow-up. Among 6208 matched patients and during 22,142 person-years of follow-up, 57 (1.8%) and 42 (1.4%) AMD cases occurred in BP users and non-BP users, respectively. The survival analysis model did not provide significant evidence of a higher risk of AMD in BP users (subhazard ratio: 1.60; 95% confidence interval (CI): 0.95–2.72; P = 0.08), although there was a significant increased risk among BP users with high medication possession ratio (MPR) (top quartile) relative to non-BP users (odds ratio: 5.08, 95% CI: 3.11–8.30; P < 0.001, respectively). Overall, oral BP use was not associated with an increased risk of AMD in this cohort of hip fracture patients, although the risk increased significantly with higher MPR. More data are needed to confirm these findings.

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Accepted/In Press date: 4 December 2017
e-pub ahead of print date: 24 January 2018

Identifiers

Local EPrints ID: 417572
URI: https://eprints.soton.ac.uk/id/eprint/417572
ISSN: 0077-8923
PURE UUID: 5a2cc28a-d1bc-4df1-8e9f-2565bec81001
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 05 Feb 2018 17:30
Last modified: 06 Jun 2018 13:00

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Contributors

Author: C. Garriga
Author: Michael Pazianas
Author: Samuel Hawley
Author: A. Delmestri
Author: D Prieto-Alhambra
Author: Cyrus Cooper ORCID iD
Author: Andrew Judge

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