Original articles: Asthma, rhinitis, other respiratory diseases
Risk of cataract among users of intranasal corticosteroids,☆☆

https://doi.org/10.1067/mai.2000.106044Get rights and content
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Abstract

Background: Oral corticosteroid users are at increased risk of cataract, but the risk among intranasal corticosteroids users is unknown. Objective: Our purpose was to describe the risk of cataract among users of intranasal steroids. Methods: A retrospective observational cohort study of cataract incidence was conducted among users of oral and intranasal steroids identified from the United Kingdom–based General Practice Research Database with a nested case-control analysis to control for confounding factors. The study population included 286,078 subjects aged less than 70 years old drawn from 350 general practices in England and Wales. Patients were classified as users of only intranasal corticosteroids, users of only oral corticosteroids, and nonusers of either medication. Computerized medical records were used to identify cases of cataract. Two hundred twenty-five cases were randomly selected for validation against general practitioners’ held referral and hospitalization letters. Results: The incidence rate of cataract (1.0/1000 person-years) among users of intranasal corticosteroids was similar to the incidence rate among nonusers. However, oral corticosteroid users were at higher risk of cataract (2.2/1000 person-years). Approximately 70% of intranasal corticosteroid exposure was to beclomethasone dipropionate only; the event rate in this group was similar to that in the unexposed group. Cataract risk did not increase with the number of prior prescriptions for intranasal corticosteroids. Conclusion: The use of intranasal corticosteroids was not associated with an increased risk of cataracts in this study population. (J Allergy Clin Immunol 2000;105:912-6.)

Keywords

Intranasal corticosteroids
cataract
beclomethasone dipropionate

Abbreviations

CI:
Confidence interval
COPD:
Chronic obstructive pulmonary disease
GP:
General practitioner
GPRD:
General Practice Research Database
ICD:
International Classification of Diseases
OXMIS:
Oxford Medical Information System
RR:
Relative risk

Cited by (0)

The Boston Collaborative Drug Surveillance Program is supported in part by grants from AstraZeneca, Bayer AG, Berlex Laboratories, Boots Healthcare International, Bristol-Myers Squibb Pharmaceutical Research Institute, GlaxoWellcome Inc, Hoffmann-La Roche Ltd, Janssen Pharmaceutica Products, LP, RW Johnson Pharmaceutical Research Institute, McNeil Consumer Products Company, and Novartis Farmacéutica SA. This study was funded by GlaxoWellcome Inc.

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Reprint requests: Laura E. Derby, DSc, Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, 11 Muzzey St, Lexington, MA 02421.