PMID- 31194953
OWN - NLM
STAT- MEDLINE
DCOM- 20200320
LR  - 20200320
IS  - 1879-1891 (Electronic)
IS  - 0002-9394 (Linking)
VI  - 207
DP  - 2019 Nov
TI  - Lipid-Lowering Medications Are Associated with Lower Risk of Retinopathy and 
      Ophthalmic Interventions among United States Patients with Diabetes.
PG  - 378-384
LID - S0002-9394(19)30264-8 [pii]
LID - 10.1016/j.ajo.2019.05.029 [doi]
AB  - PURPOSE: To evaluate the impact of lipid-lowering medications on diabetic 
      retinopathy and diabetic complications requiring intervention in the US 
      population. DESIGN: Retrospective cohort analysis. METHODS: Administrative 
      insurance claims were drawn from the Truven MarketScan Commercial Claims and 
      Encounters databases. Population consisted of beneficiaries with type 2 diabetes 
      mellitus (T2DM). Main outcome measurements were any signs of diabetic 
      retinopathy, as measured by diagnosis codes for nonproliferative diabetic 
      retinopathy (NPDR), proliferative diabetic retinopathy (PDR), or diabetic macular 
      edema (DME) and procedure codes for retinopathy treatments (anti-VEGF injections, 
      laser therapy, and vitrectomy). RESULTS: A population of 269,782 patients 
      diagnosed with T2DM between 2008 and 2015 were analyzed. A total of 99,233 
      patients (37%) were undergoing treatment with lipid-lowering medications. 
      Approximately 6% of patients taking lipid-lowering medications had a diagnosis 
      code for NPDR, PDR, or DME or a procedural code for intravitreal injections, pars 
      plana vitrectomy (PPV) or laser treatment in their record following diagnosis 
      with diabetes compared to 6.5% of patients who did not take lipid-lowering 
      medications (P < 0.01). In adjusted time-to-event analyses, patients who took 
      lipid-lowering medications prior to diagnosis of T2DM were less likely to 
      progress to any retinopathy diagnosis (hazard ratio [HR], 0.60; 95% confidence 
      interval [CI], 0.55-0.65) and less likely to receive any treatment for 
      retinopathy (HR, 0.81; 95% CI, 0.78-0.84). These findings were significant at the 
      aggregate level, at the individual level of diagnosis (NPDR HR, 0.63; 95% CI, 
      0.57-0.69; PDR HR, 0.45; 95% CI, 0.37-0.54; and DME HR, 0.39; 95% CI, 0.33-0.45), 
      and at the level of each treatment category (anti-VEGF injection HR, 0.81; 95% 
      CI, 0.78-0.84; laser HR, 0.62; 95% CI, 0.47-0.81; and vitrectomy HR, 0.71; 95% 
      CI, 0.59-0.85). CONCLUSIONS: This study found consistent evidence that patients 
      taking lipid-lowering medications were less likely to develop NPDR, PDR, or DME 
      and modest evidence that these patients are less likely to receive intravitreal 
      injections of anti-VEGF medication, laser treatments, or vitrectomy. The study 
      validates the findings of studies that have used claims databases in East Asia in 
      relatively homogeneous populations to estimate an association between statin use 
      and retinopathy, replicating them in a US context in a large commercial claims 
      database.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Vail, Daniel
AU  - Vail D
AD  - Department of Ophthalmology, Byers Eye Institute, Stanford University School of 
      Medicine, Palo Alto, California, USA.
FAU - Callaway, Natalia F
AU  - Callaway NF
AD  - Department of Ophthalmology, Byers Eye Institute, Stanford University School of 
      Medicine, Palo Alto, California, USA.
FAU - Ludwig, Cassie A
AU  - Ludwig CA
AD  - Department of Ophthalmology, Byers Eye Institute, Stanford University School of 
      Medicine, Palo Alto, California, USA.
FAU - Saroj, Namrata
AU  - Saroj N
AD  - All Eyes Consulting, LLC, New York, New York, USA.
FAU - Moshfeghi, Darius M
AU  - Moshfeghi DM
AD  - Department of Ophthalmology, Byers Eye Institute, Stanford University School of 
      Medicine, Palo Alto, California, USA. Electronic address: dariusm@stanford.edu.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190610
PL  - United States
TA  - Am J Ophthalmol
JT  - American journal of ophthalmology
JID - 0370500
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Fibric Acids)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Hypolipidemic Agents)
RN  - 0 (VEGFA protein, human)
RN  - 0 (Vascular Endothelial Growth Factor A)
SB  - IM
MH  - Adult
MH  - Angiogenesis Inhibitors/therapeutic use
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Diabetic Retinopathy/diagnosis/*epidemiology/therapy
MH  - Female
MH  - Fibric Acids/therapeutic use
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
MH  - Hypolipidemic Agents/*therapeutic use
MH  - Intravitreal Injections
MH  - Laser Coagulation
MH  - Macular Edema/diagnosis/*epidemiology/therapy
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - United States/epidemiology
MH  - Vascular Endothelial Growth Factor A/antagonists & inhibitors
MH  - Visual Acuity
MH  - Vitrectomy
EDAT- 2019/06/14 06:00
MHDA- 2020/03/21 06:00
CRDT- 2019/06/14 06:00
PHST- 2019/02/28 00:00 [received]
PHST- 2019/05/27 00:00 [revised]
PHST- 2019/05/31 00:00 [accepted]
PHST- 2019/06/14 06:00 [pubmed]
PHST- 2020/03/21 06:00 [medline]
PHST- 2019/06/14 06:00 [entrez]
AID - S0002-9394(19)30264-8 [pii]
AID - 10.1016/j.ajo.2019.05.029 [doi]
PST - ppublish
SO  - Am J Ophthalmol. 2019 Nov;207:378-384. doi: 10.1016/j.ajo.2019.05.029. Epub 2019 
      Jun 10.