Association of lipid-lowering drugs and antidiabetic drugs with age-related macular degeneration: a meta-analysis in Europeans

Abstract

Background/aimsTo investigate the association of commonly used systemic medications with prevalent age-related macular degeneration (AMD) in the general population.MethodsWe 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.ResultsBetween 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.ConclusionOur 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.

Influence of metformin on age-related macular degeneration

“…In contrast, a very recently published meta-analysis by Mauschitz et al over 14 European population-or hospitalbased studies found a lower AMD prevalence in patients taking lipid-lowering and/or antidiabetic drugs (including metformin) (OR 0.78; 95% CI, p = 0.002) [47]. However, no association was found for late AMD stages (OR 1.12, 95% CI, p = 0.37).…”

Altersbedingte Makuladegeneration in einer alternden Gesellschaft – aktuelle epidemiologische Forschungsansätze und Erkenntnisse

“…Diskutiert wird z. B. ein positiver Effekt von Metformin 32 , 33 . Biologisch plausibel wäre dies, da Metformin antioxidative und antiinflammatorische Eigenschaften besitzt und oxidativen Stress im RPE reduzieren kann 34 .…”

“…Current epidemiological research is also concerned with the influence of long-term medication on the occurrence and progression of AMD in older patients. For example, a positive effect of metformin is under discussion 32 , 33 . Biologically, this would be plausible because metformin has antioxidant and anti-inflammatory properties and can reduce oxidative stress in the retinal pigment epithelium 34 .…”

Seven days in medicine: 2-8 November 2022

“…A pooled data analysis of 38 694 people in Europe published in the British Journal of Ophthalmology found that drugs to lower cholesterol or control diabetes were associated with, respectively, a 15% and 22% lower prevalence of any type of age related macular degeneration (AMD), after accounting for potentially influential factors. The researchers said that longitudinal data would be needed to confirm the findings but that they pointed to a likely key role for metabolic processes in the development of AMD, which they said may offer potential new avenues for treatment and public health messaging 2…”