Background/aims To investigate the association of commonly used systemic medications with prevalent age-related macular degeneration (AMD) in the general population.
Methods We included 38 694 adults from 14 population-based and hospital-based studies from the European Eye Epidemiology consortium. We examined associations between the use of systemic medications and any prevalent AMD as well as any late AMD using multivariable logistic regression modelling per study and pooled results using random effects meta-analysis.
Results Between studies, mean age ranged from 61.5±7.1 to 82.6±3.8 years and prevalence ranged from 12.1% to 64.5% and from 0.5% to 35.5% for any and late AMD, respectively. In the meta-analysis of fully adjusted multivariable models, lipid-lowering drugs (LLD) and antidiabetic drugs were associated with lower prevalent any AMD (OR 0.85, 95% CI=0.79 to 0.91 and OR 0.78, 95% CI=0.66 to 0.91). We found no association with late AMD or with any other medication.
Conclusion Our study indicates a potential beneficial effect of LLD and antidiabetic drug use on prevalence of AMD across multiple European cohorts. Our findings support the importance of metabolic processes in the multifactorial aetiology of AMD.
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information. Study data may be available upon reasonable request.
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Contributors MMM and RPF contributed to the conception and design, analysed data and wrote the initial version of the manuscript. TV, AKS, HE, NP, AK, RNL, PJF, FGR, KW, TK, JBJ, MMB, RH, TP, AC-G, GB, MGE, FT, DAG, CB, IMH, CPC-G, P-HG, H-WH, DP, PB, RC, SP, VD, FGH and CD performed data collection, contributed to study design and wrote the manuscript. All authors read and approved the final manuscript. Guarantor: MMM.
Funding The Alienor study received financial support from Laboratoires Théa (Clermont-Ferrand, France). Laboratoires Théa participated in the design of the study, but no sponsor participated in the collection, management, statistical analysis and interpretation of the data, nor in the preparation, review or approval of the present manuscript. The Gutenberg Health Study is funded through the government of Rhineland-Palatinate (‘Stiftung Rheinland-Pfalz fuer Innovation’, contract AZ 961-386261/733), the research programmes ‘Wissen schafft Zukunft’ and ‘Center for Translational Vascular Biology (CTVB)’ of the Johannes Gutenberg University of Mainz, and its contract with Boehringer Ingelheim and PHILIPS Medical Systems, including an unrestricted grant for the Gutenberg Health Study. AKS holds the professorship for ophthalmic healthcare research endowed by 'Stiftung Auge' and financed by 'Deutsche Ophthalmologische Gesellschaft' and 'Berufsverband der Augenärzte Deutschland e.V.'. AugUR: Investigations and analyses are supported by grants from the German Federal Ministry of Education and Research (BMBF 01ER1206, BMBF 01ER1507 to IMH), by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation; HE 3690/7-1 and HE 3690/5-1 to IMH, BR 6028/2-1 to CB) and by the National Institutes of Health (NIH R01 EY RES 511967 to IMH). MARS (Münster Aging and Retina Study) was supported by Deutsche Forschungsgemeinschaft (DFG) Grants HE 2293/5-1, 5-2, 5-3 and PA 357/7-1, the Intramural International Monetary Fund of the University of Muenster, the Pro Retina Foundation and the Jackstaedt Foundation (DP, HWH). The EPIC-Norfolk study (DOI 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (MR/N003284/1 and MC-UU_12015/1) and Cancer Research UK (C864/A14136). The clinic for the third health examination was funded by Research into Ageing (262). We are grateful to all the participants who have been part of the project and to the many members of the study teams at the University of Cambridge who have enabled this research. AK is funded by a UKRI Future Leaders Fellowship (Medical Research Council MR/T040912/1). RNL is funded by a Moorfields Eye Charity Springboard Award. PJF is supported by an unrestricted grant from Alcon and the Desmond Foundation. This publication is supported by the Leipzig Research Centre for Civilization Diseases (LIFE), an organisational unit affiliated to the Medical Faculty of Leipzig University. LIFE is funded by means of the European Union, by the European Regional Development Fund (ERDF) and by funds of the Free State of Saxony within the framework of the excellence initiative (project numbers: 713-241202, 14505/2470, 14575/2470). FGR is supported by a grant from the German Federal Ministry of Education and Research: i:DSem—Integrative data semantics in systems medicine (031L0026). The authors wish to express their sincere thanks to the participants of LIFE-Adult for their time. The authors gratefully acknowledge KW and her team at the Leipzig Research Center for Civilization Diseases (LIFE-Adult), Leipzig University, Leipzig, Germany for data acquisition. The NICOLA study is funded by the Atlantic Philanthropies, the Economic and Social Research Council, the UKCRC Centre of Excellence for Public Health Northern Ireland, the Centre for Aging Research and Development in Ireland, the Office of the First Minister and Deputy First Minister, the Health and Social Care Research and Development Division of the Public Health Agency, the Wellcome Trust/Wolfson Foundation and Queen’s University Belfast. CRESCENDO study was carried out with the financial support of the ANR—Agence Nationale de la Recherche (MALZ-007-01—The French National Research Agency—and grants from the “Chercheur d’Avenir” (R12028FF) and Aide à la Recherche en Partenariat avec les Entreprises (ARPE; RPH12007F) allocated by the Languedoc Roussillon administrative regional district (France). The Coimbra Eye Study was funded by Novartis.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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