Abstract
Purpose
To investigate the association between the use of topical β-blockers and subsequent asthma attacks in glaucoma patients with asthma.
Methods
This was a retrospective longitudinal cohort study using an administrative claims database. All patients aged 20 years or older who were registered in the health insurance claims database updated and managed by JMDC Inc. (Tokyo, Japan). Patients who were newly prescribed eye drops for glaucoma treatment were identified between 2011 and 2017. The patients with glaucoma were divided into two groups: β-blocker users and non-β-blocker users, based on the presence of a β-blocker in the prescribed eye drops. We investigated whether the incidence of asthma attacks in patients with previously treated asthma differed between the two groups.
Results
We categorized 17,666 patients in the β-blocker-user group and 12,609 patients in the non-β-blocker-user group. A total of 580 patients in the β-blocker group (3.28%) and 847 in the non-β-blocker group (6.72%) underwent asthma treatment before the prescription of anti-glaucoma eye drops (P < 0.001). Furthermore, 94 patients in the β-blocker-user group (0.53%) and 278 in the non-β-blocker user group (2.20%) were undergoing current treatment for asthma (P < 0.001). The adjusted hazard ratios of asthma attacks were 0.73 (95% confidence interval, 0.46–1.16, P = 0.18) in patients with a history of asthma treatment and 1.22 (95% confidence interval, 0.56–2.70, P = 0.62) in patients with current asthma treatment, compared to the non-β-blocker-user group.
Conclusion
Our results clarified that several patients with asthma were prescribed topical β-blockers for glaucoma treatment. However, asthma attacks may not be significantly attributed to topical β-blockers, even in glaucoma patients under current asthma treatment. The administration of topical β-blockers to asthma patients could be a treatment option in the absence of other treatment options, if adequate informed consent is obtained. Further studies are needed to draw a firm conclusion on this clinical question.
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Data availability
The data for this study are the claims data provided by JMDC Inc. (Tokyo, Japan) and we still have access to all the data we used.
Code availability
The program codes used during the current study are available from the corresponding author on reasonable request.
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Dr Kawakami had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors meet the criteria for authorship.
Concept and design: AK, MM, TA, SY.
Acquisition: KK.
Analysis, or interpretation of data: All authors.
Drafting of the manuscript: AK, MM, SY, HT.
Critical revision of the manuscript for important intellectual content: All authors.
Administrative, technical, or material support: KK, HT, AT.
Supervision: KK, HT.
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The study was approved by the Ethics Committee of Kyoto University Graduate School and Faculty of Medicine (No. R1816).
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The need for informed consent was waived because all information had been legally anonymized by JMDC Inc.
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The authors declare no competing interests.
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Koji Kawakami and Hiroshi Tamura jointly directed this work.
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Kido, A., Miyake, M., Akagi, T. et al. Association between topical β-blocker use and asthma attacks in glaucoma patients with asthma: a cohort study using a claims database. Graefes Arch Clin Exp Ophthalmol 260, 271–280 (2022). https://doi.org/10.1007/s00417-021-05357-z
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DOI: https://doi.org/10.1007/s00417-021-05357-z