June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Effect of tadalafil on progression of age-related macular degeneration
Author Affiliations & Notes
  • Tracy Lang
    USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • John O'Fee
    USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Khristina Lung
    University of Southern California Leonard D Schaeffer Center for Health Policy and Economics, Los Angeles, California, United States
  • David S Boyer
    Retina Vitreous Assoc Med Group, California, United States
  • Andrew A Moshfeghi
    USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Brian C Toy
    USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Tracy Lang None; John O'Fee None; Khristina Lung None; David Boyer Apellis, Iveric, InflammX, Annexon, Novartis, Code F (Financial Support); Andrew Moshfeghi None; Brian Toy None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1135. doi:
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      Tracy Lang, John O'Fee, Khristina Lung, David S Boyer, Andrew A Moshfeghi, Brian C Toy; Effect of tadalafil on progression of age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1135.

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

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Abstract

Purpose : Phosphodiesterase-5 (PDE5) inhibitors have potential effects on age-related macular degeneration (AMD) pathophysiology, particularly to increase choroidal perfusion and thickness. Tadalafil, a PDE5 inhibitor that is dosed daily for benign prostatic hypertrophy, could ameliorate the choroidal ischemia which may cause progression to advanced dry AMD. Conversely, the increased choroidal perfusion promoted by tadalafil could lead to the development of wet AMD. Employing a national health insurance claims database, we performed a retrospective cohort study to assess the effect of tadalafil use on progression of AMD.

Methods : Employing a national health insurance claims database, we identified patients aged 55 and older with an index ICD-10 diagnosis of early or intermediate AMD. Patients were included who had a 2-year period of continuous enrollment prior to the index diagnosis date, without any exclusion criteria: claims for a PDE5 inhibitor other than tadalafil during the lookback and follow-up periods, diagnoses of advanced dry or wet AMD and claims for wet AMD treatment during the lookback. Treated patients with claims for tadalafil during the lookback or follow-up were matched 1:1 to untreated controls by age, sex, race, and smoking status. The effect of cumulative tadalafil use during the follow-up was categorized as being above or below the 50th percentile (0-600 mg, >600 mg). Two models were constructed to assess the effect of any tadalafil use (model 1) and the effect of low vs high cumulative dose tadalafil (model 2) on incidence of advanced dry or wet AMD during the 2 years post-index date. The models were analyzed with univariate and multivariable regression. Multivariable models adjusted for age, sex, race, education, and smoking status.

Results : There was no significant difference in odds of progression to wet AMD (OR=0.818, p=0.282) or advanced dry AMD (OR=1.326, p=0.350) in the control vs treated groups. >600 mg of tadalafil use (OR=0.757, p=0.328) was not associated with a significant difference in odds of progression to wet AMD when compared to the 0-600 mg treated reference group. The results for progression to advanced dry AMD were similar, as the >600 mg group (OR=1.706, p=0.195) also did not show a significant difference when compared to the reference.

Conclusions : In a retrospective cohort study of a large nationwide health insurance database, tadalafil use was not associated with progression of AMD.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

 

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