April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The Impact of Bupropion Use on the Risk of Open-Angle Glaucoma
Author Affiliations & Notes
  • Joshua D Stein
    Kellogg Eye Center/Ophthal, University of Michigan, Ann Arbor, MI
  • Nidhi Talwar
    Kellogg Eye Center/Ophthal, University of Michigan, Ann Arbor, MI
  • Jae H Kang
    Medicine, Brigham and Women, Boston, MA
  • Janey L Wiggs
    Ophthalmology, Harvard Medical School, Boston, MA
  • Louis R Pasquale
    Ophthalmology, Harvard Medical School, Boston, MA
    Medicine, Brigham and Women, Boston, MA
  • Footnotes
    Commercial Relationships Joshua Stein, None; Nidhi Talwar, None; Jae Kang, None; Janey Wiggs, None; Louis Pasquale, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1666. doi:
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      Joshua D Stein, Nidhi Talwar, Jae H Kang, Janey L Wiggs, Louis R Pasquale; The Impact of Bupropion Use on the Risk of Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1666.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Tumor Necrosis Factor (TNF) mediates retinal ganglion cell death in glaucoma. Anti-TNF drugs are neuroprotective in an animal model of glaucoma. Bupropion is a commonly prescribed agent with an acceptable side effect profile that has anti-TNF properties. The purpose of this study is to determine whether bupropion use is associated with the risk of developing open-angle glaucoma (OAG).

 
Methods
 

Claims data from a cohort of patients age ≥35 years who were continuously enrolled in a nationwide U.S. managed care plan for ≥4 years in which beneficiaries had at ≥2 visits to an eye-care provider between 2001-2011 were reviewed. The amount of bupropion use for each enrollee was captured from outpatient pharmacy claims over a four-year period. Multivariable Cox regression analyses were performed to determine whether bupropion use affected the hazard of developing incident OAG. Regression models were adjusted for sociodemographic factors, medical and ocular comorbidities.

 
Results
 

Of 638,481 eligible enrollees, 15,292 (2.4%) developed OAG. After adjustment for confounding factors including selective serotonin reuptake inhibitors and tricyclic antidepressants, each additional month of bupropion was associated with a 0.6% reduced risk of OAG (HR = 0.994, [95% CI: 0.989-0.998], p=0.007). Compared to nonusers, 36-48 months of bupropion use was associated with a 22% reduced hazard (HR = 0.78, [95% CI: 0.60-1.00]; p=0.05) of OAG (p for trend=0.007). This association did not differ among persons with vs. without depression (p-interaction =0.65).

 
Conclusions
 

These findings suggest that bupropion use may be beneficial in reducing the risk of OAG. If prospective studies confirm the findings of this analysis, this may identify novel therapeutic targets for OAG and explain why disease progresses in some patients despite normalization of intraocular pressure.

 
Keywords: 464 clinical (human) or epidemiologic studies: risk factor assessment • 629 optic nerve  
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