Use of Topiramate and Risk of Glaucoma: A Case-Control Study

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• 作者：Mahyar Etminan^a ; ^b ; ^{mahyar.etminan@vch.ca} ; ^{metminan@shaw.ca} ; David Maberley^c ; Frederick S. Mikelberg^c
• 刊名：American Journal of Ophthalmology
• 出版年：2012
• 期刊代码：7_00029394
• 类别：med
• 出版时间：May, 2012
• 卷：153
• 期：5
• 页码：827-830
• 文件大小：162 K

摘要

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Purpose

To examine the possible link of acute-onset glaucoma with topiramate.

Design

Case-control study.

Methods

A case-control study was conducted among a cohort of subjects who had visited an ophthalmologist in the Province of British Columbia, Canada from 2000 to 2007. Cases were identified as those newly diagnosed with glaucoma (ICD-9 360). For each case, 5 controls were selected and matched to the cases by age and calendar time using density-based sampling. Crude and adjusted rate ratios (RRs) for current and past use of topiramate were computed. As a sensitivity analysis, the risk of glaucoma with a positive control drug (an oral steroid) and a negative control drug (inhaled albuterol) was also assessed.

Results

From the initial cohort of 989 591 subjects, 178 264 cases of glaucoma and 891 320 controls were identified. There was a slight increase in the risk of glaucoma among current users of topiramate (RR = 1.23 [95%confidence interval (CI), 1.09-1.40]). This risk was further elevated among new users of the drug (RR = 1.54 [95%CI, 1.09-2.17]). No increase in the risk of glaucoma requiring drug therapy was observed among current topiramate users (RR = 1.09 [95%CI, 0.80-1.61]).

Conclusion

We found an increase in the risk of glaucoma with first-time users of topiramate. Future studies are needed to confirm these findings.