Medical Compliance of Fibrate and the Decreased Risk of Age-Related Macular Degeneration in Dyslipidemia-Related Diseases: A Population-Based Cohort Study

Kai Wang, Ming-Ju Hsieh, Hsiang-Wen Chien, Chia-Yi Lee, Chao-Bin Yeh, Jing-Yang Huang and Shun-Fa Yang
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Kai Wang: Department of Ophthalmology, Cathay General Hospital, Taipei 106, Taiwan
Ming-Ju Hsieh: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Hsiang-Wen Chien: Department of Ophthalmology, Cathay General Hospital, Taipei 106, Taiwan
Chia-Yi Lee: Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 500, Taiwan
Chao-Bin Yeh: Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Jing-Yang Huang: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
Shun-Fa Yang: Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan

IJERPH, 2021, vol. 18, issue 1, 1-13

Abstract: The purpose of the current study is to evaluate the incidence of age-related macular degeneration (AMD) in dyslipidemia-related diseases with or without the use of fibrate. Patients were defined as dyslipidemia-related diseases according to the diagnostic code and lab exam arrangement, then the population was divided into those with fibrate application and those without via 1:2 ratios of propensity-score matching. The primary outcome is the development of AMD after dyslipidemia-related diseases by the Cox proportional hazard regression. Besides, the relationship between the medical compliance of fibrate, presented as medical possession ratio (MPR), and the AMD development was also analyzed. A total of 22,917 patients and 45,834 individuals were enrolled in the study and control groups. There were 572 and 1181 events of any AMD development in the study and control groups which showed identical risk of AMD (aHR: 0.94, 95% CI: 0.85–1.04). However, a reduced risk of any AMD was found in those patients reached a baseline MPR more than 20% (aHR: 0.729, 95% CI: 0.599–0.887, p = 0.0016) and overall MPR more than 5% three years after the diagnosis of dyslipidemia-related diseases (aHR: 0.712, 95% CI: 0.557–0.909, p = 0.0065). Besides, a lower risk of dry-AMD was also found in those patients with the above conditions (aHR: 0.736, 95% CI: 0.599–0.906, p = 0.0038 and aHR: 0.721, 95% CI: 0.557–0.934, p = 0.0133, respectively). In conclusion, the use of fibrate with fair initial medical compliance will decrease the incidence of AMD in patients with dyslipidemia-related diseases, especially for the development of dry-AMD.

Keywords: age-related macular degeneration; epidemiology; fibrate; dyslipidemia; compliance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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