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Association between topical β-blocker use and asthma attacks in glaucoma patients with asthma: a cohort study using a claims database

Graefe's Archive for Clinical and Experimental Ophthalmology volume 260, pages 271–280 (2022)Cite this article

Abstract

Purpose

To investigate the association between the use of topical β-blockers and subsequent asthma attacks in glaucoma patients with asthma.

Methods

This was a retrospective longitudinal cohort study using an administrative claims database. All patients aged 20 years or older who were registered in the health insurance claims database updated and managed by JMDC Inc. (Tokyo, Japan). Patients who were newly prescribed eye drops for glaucoma treatment were identified between 2011 and 2017. The patients with glaucoma were divided into two groups: β-blocker users and non-β-blocker users, based on the presence of a β-blocker in the prescribed eye drops. We investigated whether the incidence of asthma attacks in patients with previously treated asthma differed between the two groups.

Results

We categorized 17,666 patients in the β-blocker-user group and 12,609 patients in the non-β-blocker-user group. A total of 580 patients in the β-blocker group (3.28%) and 847 in the non-β-blocker group (6.72%) underwent asthma treatment before the prescription of anti-glaucoma eye drops (P < 0.001). Furthermore, 94 patients in the β-blocker-user group (0.53%) and 278 in the non-β-blocker user group (2.20%) were undergoing current treatment for asthma (P < 0.001). The adjusted hazard ratios of asthma attacks were 0.73 (95% confidence interval, 0.46–1.16, P = 0.18) in patients with a history of asthma treatment and 1.22 (95% confidence interval, 0.56–2.70, P = 0.62) in patients with current asthma treatment, compared to the non-β-blocker-user group.

Conclusion

Our results clarified that several patients with asthma were prescribed topical β-blockers for glaucoma treatment. However, asthma attacks may not be significantly attributed to topical β-blockers, even in glaucoma patients under current asthma treatment. The administration of topical β-blockers to asthma patients could be a treatment option in the absence of other treatment options, if adequate informed consent is obtained. Further studies are needed to draw a firm conclusion on this clinical question.

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Data availability

The data for this study are the claims data provided by JMDC Inc. (Tokyo, Japan) and we still have access to all the data we used.

Code availability

The program codes used during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Ai Kido, Masahiro Miyake, Tadamichi Akagi, Hanako Ohashi Ikeda, Takanori Kameda, Kenji Suda, Tomoko Hasegawa, Akitaka Tsujikawa & Hiroshi Tamura

  2. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan

    Ai Kido, Satomi Yoshida & Koji Kawakami

  3. Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan

    Shusuke Hiragi

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Contributions

Dr Kawakami had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors meet the criteria for authorship.

Concept and design: AK, MM, TA, SY.

Acquisition: KK.

Analysis, or interpretation of data: All authors.

Drafting of the manuscript: AK, MM, SY, HT.

Critical revision of the manuscript for important intellectual content: All authors.

Administrative, technical, or material support: KK, HT, AT.

Supervision: KK, HT.

Corresponding author

Correspondence to Koji Kawakami.

Ethics declarations

Ethics approval

The study was approved by the Ethics Committee of Kyoto University Graduate School and Faculty of Medicine (No. R1816).

Consent to participate

The need for informed consent was waived because all information had been legally anonymized by JMDC Inc.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

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Koji Kawakami and Hiroshi Tamura jointly directed this work.

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Kido, A., Miyake, M., Akagi, T. et al. Association between topical β-blocker use and asthma attacks in glaucoma patients with asthma: a cohort study using a claims database. Graefes Arch Clin Exp Ophthalmol 260, 271–280 (2022). https://doi.org/10.1007/s00417-021-05357-z

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  • DOI: https://doi.org/10.1007/s00417-021-05357-z

Keywords

  • Glaucoma
  • β-blocker
  • Asthma
  • Adverse event
  • Administrative database
  • Claims database