Statin use lowers diabetic retinopathy risk
medwireNews: Statin therapy may reduce the risk of diabetic retinopathy and the need for its associated invasive treatments in patients with type 2 diabetes and dyslipidaemia, population-based study findings indicate.
Furthermore, the benefits of statin use increased with increasing statin intensity and patient adherence, Yih-Shiou Hwang (Linkou Medical Center, Taoyuan, Taiwan) and co-authors report.
The researchers found that during a mean 7.6 years of follow-up, diabetic retinopathy developed in 10.6% of 18 ,947 patients with type 2 diabetes and dyslipidaemia who were regular statin users (medication possession rate ≥80%) between 1998 and 2013.
This compared with a rate of 12.0% during a mean 7.3 years of follow-up among 18 ,947 propensity-score matched patients with type 2 diabetes and dyslipidaemia who did not use statins.
The hazard ratio (HR) for diabetic retinopathy was a significant 0.86 in favour of statin use, indicating that the drug may reduce the risk of this outcome by 14%.
Compared with nonusers, statin users also had significantly lower risks of both nonproliferative (HR=0.92) and proliferative diabetic retinopathy (HR=0.64), including vitreous haemorrhage (HR=0.62) and tractional retinal detachment (HR=0.61), as well as a reduced risk of macular oedema (HR=0.60).
In line with this, patients in the statin group had significantly lower rates of surgical intervention, such as retinal laser treatment (5.2 vs 7.1%), intravitreal injection (1.0 vs 1.3%) and vitrectomy (1.0 vs 1.6%) than those in the non-statin group.
Among the patients who required surgical intervention, the mean number of treatments per 10 years was significantly lower with statin use than without, at 3.30 versus 5.11 for retinal laser therapy, 0.35 versus 0.50 for intravitreal injection, and 0.17 versus 0.54 for vitrectomy.
In a separate analysis of the total cohort of statin users before propensity matching (n=199,760), Hwang and team found that the risk of diabetic retinopathy increased with decreasing statin intensity, with overall rates ranging from 3.4% among patients using a high-intensity statin to 13.4% among those on low-intensity statin therapy.
Similar results were observed for medication adherence; the diabetic retinopathy rate was 7.1% among patients with a medication possession rate at or above 80% and 10.1% among patients with a medication possession rate below 80%.
Additional benefits of statin use versus no use included significantly reduced risks of new-onset diabetic foot ulcers (HR=0.73), major adverse cardiovascular events (HR=0.81) and new-onset diabetic neuropathy (HR=0.85), the researchers report in JAMA Ophthalmology.
They conclude that their findings, when taken together with those of the ACCORD-EYE study, “could offer medical strategies to reduce the risk of diabetic retinopathy.”
By Laura Cowen
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