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Br J Ophthalmol 2004;88:196-198 doi:10.1136/bjo.2003.017715
  • Clinical science
    • Scientific reports

Do selective topical β antagonists for glaucoma have respiratory side effects?

  1. J F Kirwan1,2,
  2. J A Nightingale3,
  3. C Bunce2,
  4. R Wormald2
  1. 1Institute of Ophthalmology, London, UK
  2. 2Moorfields Eye Hospital, London, UK
  3. 3Department of Respiratory Medicine, Hammersmith Hospital, London, UK
  1. Correspondence to: James F Kirwan Department of Epidemiology and International Eye Health, Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK; jfkirwanucl.ac.uk
  • Accepted 5 March 2003

Abstract

Background/aims: Topical β antagonists are prescribed for glaucoma in approximately 500 000 people in the United Kingdom. The authors have previously shown that topical β antagonists are associated with an excess incidence of airways obstruction. They examined whether selective topical β antagonists are associated with excess airways obstruction.

Methods: A historical cohort study was performed to determine the incidence of airways obstruction in subjects with no previous history of airways obstruction, following treatment with topical β antagonists for glaucoma for the period 1993–7. Cases were defined as having received a first prescription of a drug specifically used in the management of airways obstruction.

Results: For selective topical β antagonists 12 of 324 treated subjects developed airways obstruction, compared with 112 of 9094 controls (adjusted hazard rate 3.0 (95% confidence interval (95% CI) 1.6 to 5.4)). For non-selective topical β antagonists, the corresponding figures were 69 of 2321 subjects compared with the same control group (adjusted hazard rate 2.2 (1.6 to 3.0)). There was no significant difference between groups (p = 0.47, χ2), both being associated with a significantly increased risk of airways obstruction.

Conclusion: Selective topical β antagonists do appear to have an excess risk of airways obstruction in this population setting and should be subject to the same prescribing caveats as unselective topical β antagonists.

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