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Irmak Karaca, Wataru Matsumiya, Amir Akhavanrezayat, Gunay Uludag, Cigdem Yasar, Azadeh Mobasserian, Jaclyn Joyce Hwang, Sherin Lajevardi, Brandon Chau Lam, Rubbia Afridi, Diana V Do, Yasir J Sepah, Quan Dong Nguyen; Association of oral montelukast with reduced odds of developing neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2021;62(8):275.
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Given the role of chronic inflammation in the pathogenesis of age-related macular degeneration (AMD), montelukast might have a potential protective impact on the development of neovascular AMD (nAMD) through an anti-inflammatory effect including its selective antagonism for cysteinyl leukotriene receptor 1 (CysLTR1). The proposed case-control study aimed to evaluate the association of oral montelukast with reduced odds of nAMD development.
The index study was conducted using Institutional Cohort Finder tool, and included 1913 patients who were diagnosed as nAMD (ICD: H35.32 and 362.52) and visited the Byers Eye Institute at Stanford from 1991 to 2020, and 1913 age- and gender- matched control subjects without nAMD. The subjects were assessed for the presence of nAMD risk factors (e.g. smoking history, Caucasian race, hypertension, hyperlipidemia) and for the use of specific medications (e.g. oral montelukast, nasal or oral cromolyn [mast cell stabilizer], oral steroids, oral NSAIDs, oral H1-antihistamines). Then, the odds ratio (OR) calculations using multivariable conditional logistic regression analyses were performed in order to assess the effect of oral montelukast use on reducing the odds of nAMD development, adjusting for possible risk factors.
A total of 47 (2.5%) nAMD cases were identified to have a history of oral montelukast use prior to nAMD diagnosis, compared to 84 (4.4%) controls (crude OR: 0.54, P=0.0001). In the multivariable analysis, montelukast usage was significantly associated with reduced odds of nAMD (adjusted OR: 0.57, P=0.004). On the other hand, Caucasian race (adjusted OR 1.52, P<0.0001), history of smoking (adjusted OR: 1.91, P<0.0001), and NSAIDs use (adjusted OR: 0.75, P=0.005) were found to have significant relationship with increased odds of nAMD.
The study results suggested that oral montelukast consumption is linked to reduced odds of nAMD development. Future prospective cohort studies is needed to validate these findings.
This is a 2021 ARVO Annual Meeting abstract.
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