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Purpose <p>This study investigated the association between fibrate use and the risk of open-angle glaucoma (OAG) in patients with hyperlipidemia.</p> Methods <p>A nationwide retrospective cohort study was conducted using Taiwan’s Longitudinal Generation Tracking Database (LGTD 2000). Patients aged ≥ 50&#xa0;years newly diagnosed with hyperlipidemia between 2001 and 2013 were included. New fibrate users were stratified by adherence, with higher proportion of days covered (PDC) users (≥ 50%) as the exposure group, while lower PDC users (20–50%) and nonusers served as comparators. Propensity score matching (1:1) created balanced cohorts, followed for up to five years. OAG risk was estimated using marginal Cox models.</p> Results <p>In matched cohorts, OAG incidence was 4.98 per 1000 person-years in higher PDC users and 3.29 in lower PDC users. Compared with nonusers, higher PDC users had 4.78 versus 2.83 per 1000 person-years. Higher PDC was not significantly associated with OAG risk versus lower PDC (adjusted hazard ratio [aHR] 1.48; 95% confidence interval [CI] 0.95–2.29), but risk was elevated compared with nonuse (aHR 1.68; 95% CI 1.09–2.61). Patients with ≥ 303 cumulative defined daily doses/year and those treated ≥ 2&#xa0;years had increased risks, with aHRs of 3.75 (95% CI 2.21–6.38) and 1.70 (95% CI 1.04–2.76), both showing linear trends.</p> Conclusion <p>Higher cumulative doses and longer duration of fibrate therapy were associated with increased OAG incidence. These findings require further evaluation, including clinical and cost-effectiveness considerations, before routine ophthalmologic surveillance is considered.</p>

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Contrasting with prior findings: a population-based cohort study of fibrate exposure and open-angle glaucoma risk in patients with hyperlipidemia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月22日

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  • Guan-Ling Lin,
  • Shih-Chia Lin,
  • Joseph Jordan Keller,
  • Evelyn Jou-Chen Huang,
  • Li-Hsuan Wang

摘要

Purpose

This study investigated the association between fibrate use and the risk of open-angle glaucoma (OAG) in patients with hyperlipidemia.

Methods

A nationwide retrospective cohort study was conducted using Taiwan’s Longitudinal Generation Tracking Database (LGTD 2000). Patients aged ≥ 50 years newly diagnosed with hyperlipidemia between 2001 and 2013 were included. New fibrate users were stratified by adherence, with higher proportion of days covered (PDC) users (≥ 50%) as the exposure group, while lower PDC users (20–50%) and nonusers served as comparators. Propensity score matching (1:1) created balanced cohorts, followed for up to five years. OAG risk was estimated using marginal Cox models.

Results

In matched cohorts, OAG incidence was 4.98 per 1000 person-years in higher PDC users and 3.29 in lower PDC users. Compared with nonusers, higher PDC users had 4.78 versus 2.83 per 1000 person-years. Higher PDC was not significantly associated with OAG risk versus lower PDC (adjusted hazard ratio [aHR] 1.48; 95% confidence interval [CI] 0.95–2.29), but risk was elevated compared with nonuse (aHR 1.68; 95% CI 1.09–2.61). Patients with ≥ 303 cumulative defined daily doses/year and those treated ≥ 2 years had increased risks, with aHRs of 3.75 (95% CI 2.21–6.38) and 1.70 (95% CI 1.04–2.76), both showing linear trends.

Conclusion

Higher cumulative doses and longer duration of fibrate therapy were associated with increased OAG incidence. These findings require further evaluation, including clinical and cost-effectiveness considerations, before routine ophthalmologic surveillance is considered.