Risk of cataract in patients treated with statins

Background: Studies in dogs showed that some hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) are associated with cataract when adminis tered in excessive doses. Clinical safety data of statins regarding catarac t development in humans have been of limited value so far. Objective: To determine whether long-term use of statins is associated with an increased risk of cataract. Methods: We conducted a case-control analysis using data from the United Ki ngdom-based General Practice Research Database. The main outcome was a firs t-time diagnosis of cataract and/or cataract extraction in patients aged 40 to 79 years. Controls were matched to cases on age, sex, practice, calenda r time, and duration of medical history in the database. Use of statins, fi brates, or other lipid-lowering drugs was compared with nonuse of any lipid -lowering drug, stratified by exposure duration and dose. Results: We identified 7405 cases and 28 327 controls. Long-term use of sta tins (eg, greater than or equal to 30 prescriptions) was not associated wit h an increased cataract risk (adjusted odds ratio [OR], 0.9; 95% confidence interval [CI], 0.5-1.6), nor was use of fibrates or of other lipid-lowerin g drugs (adjusted OR, 0.5; 95% Cl, 0.3-1.1; and OR, 0.7; 95% Cl, 0.1-5.6, r espectively). We found evidence that concomitant use of simvastatin and ery thromycin, a potent inhibitor of simvastatin metabolism, is associated with an increased cataract risk (adjusted odds ratio, 2.2; 95% confidence inter val, 1.2-4.1). Conclusions: Our study provides evidence that longterm use of therapeutic s tatin doses does not increase the risk of developing cataract. Concomitant use of erythromycin and simvastatin may increase the cataract risk.