Some clinicians have raised concerns regarding the potential
for lens opacities (cataracts) as a result of statin use. Statins are
prescribed to reduce total cholesterol and low-density lipoprotein cholesterol
(LDL).
Researchers used data from the British Columbia (BC)
Ministry of Health databases from 2000-2007 and the IMS LifeLink U.S. database
from 2001-2011 to form two patient cohorts. In the BC cohort, there was about a
27% increased risk of developing cataracts requiring surgical intervention,
while in the IMS cohort, the increased risk was only 7%, but still
statistically significant.
Lead investigator G.B. John Mancini, MD, of the Department
of Medicine, Faculty of Medicine, University of British Columbia, Vancouver,
Canada, said, "Further assessment of the clinical impact of this
relationship is recommended, especially given increased statin use for primary
prevention of cardiovascular disease (CVD) and the importance of acceptable vision in old age where CVD
is common. Future studies addressing the possible underlying mechanisms to
explain this association are also warranted. However, because the RR is low and
because cataract surgery is both effective and well tolerated, this association
should be disclosed but not be considered a deterrent to use of statins when
warranted for CV risk reduction."
In an accompanying editorial, Steven Gryn, MD, FRCPC, and
Robert A. Hegele, MD, FRCPC, of the Department of Medicine, Schulich School of
Medicine and Dentistry, Western University, London, Ontario, Canada, wrote,
"Any medication that has beneficial effects has potential adverse effects;
weighing the benefits against the risks is an integral part of the informed
consent process, and is central to any decision to initiate treatment. Among
patients who are at high CVD risk, like most of those seen by
cardiologists...the prevention of CVD, stroke, and their associated morbidity
and mortality vastly outweighs the risk of cataracts. Even among lower risk
patients, for whom the benefit-risk ratio is less dramatic, most patients would
still probably prefer having to undergo earlier non-life-threatening cataract
surgery over suffering a major vascular event. A randomized double-blinded
placebo-controlled clinical trial is the best way to mitigate confounding, and
such studies so far have shown no association of statins with cataracts."
The article is published in the Canadian Journal of Cardiology.
Source: Medindia
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