PDF(Pubmed)
Abstract：
Tamoxifen, a pivotal therapy for hormone receptor-positive breast cancer, is known for its efficacy in reducing breast cancer recurrence and mortality. However, concerns about potential ocular complications, particularly maculopathy, have emerged. This study aims to investigate the risk and associated factors of diverse macular conditions in tamoxifen users, considering drug exposure, demographics, and systemic diseases. A nationwide cohort of tamoxifen users, comprised of 14,267 tamoxifen users, was analyzed using the health insurance review and assessment database in South Korea. Demographic and clinical characteristics were examined, and the cumulative incidence of macular diseases was stratified by age and cumulative tamoxifen dosage. We conducted logistic regression analysis to identify potential risk factors among clinical variables such as age, sex, indications for tamoxifen use, and systemic diseases associated with various macular conditions. Additionally, Cox proportional hazard models were used to determine the baseline clinical characteristics predictive of these macular conditions, with subsequent calculation of hazard ratios. Cumulative incidences of overall macular diseases, other maculopathy excluding common macular diseases, and macular edema were 26.4, 11.4, and 6.5%, respectively. The incidence of various macular conditions increased with age and the cumulative tamoxifen dose. Age, cumulative dose group, and liver diseases demonstrated significant associations with overall macular diseases and maculopathy excluding common macular diseases in multivariate logistic regression analyses (all P < 0.05). Furthermore, age emerged as significant predictive factors of maculopathy in Cox proportional hazard models. Tamoxifen-induced maculopathy poses a concern for prescribing physicians and ophthalmologists, and this study provides valuable insights into its risk and risk factors. This study may contribute to evidence-based guidelines for tamoxifen maculopathy screening, emphasizing the importance of considering age, cumulative dose, and liver diseases for recommendation on screening timing and frequency.
摘要：
他莫昔芬,激素受体阳性乳腺癌的关键疗法，以其在减少乳腺癌复发和死亡率方面的功效而闻名。然而,关注潜在的眼部并发症，尤其是黄斑病变,出现了。本研究旨在调查他莫昔芬使用者各种黄斑疾病的风险和相关因素，考虑到药物暴露，人口统计，和系统性疾病。全国范围的他莫昔芬使用者，由14267名他莫昔芬用户组成，使用韩国的健康保险审查和评估数据库进行分析。检查了人口统计学和临床特征，黄斑疾病的累积发病率按年龄和他莫昔芬累积剂量分层。我们进行了logistic回归分析，以确定临床变量中的潜在危险因素，如年龄，性别,使用他莫昔芬的适应症，以及与各种黄斑相关的全身性疾病。此外,Cox比例风险模型用于确定预测这些黄斑疾病的基线临床特征。随后计算危险比。总体黄斑疾病的累积发病率，除常见黄斑疾病外的其他黄斑病变，黄斑水肿分别为26.4、11.4和6.5%，分别。各种黄斑疾病的发生率随着年龄和他莫昔芬累积剂量的增加而增加。年龄,累积剂量组，在多因素logistic回归分析中，肝脏疾病与总体黄斑疾病和不包括常见黄斑疾病的黄斑病变显著相关（均P<0.05）。此外，在Cox比例风险模型中,年龄是黄斑病变的重要预测因素.他莫昔芬引起的黄斑病变引起了处方医生和眼科医生的关注，这项研究为其风险和风险因素提供了有价值的见解。这项研究可能有助于他莫昔芬黄斑病变筛查的循证指南，强调考虑年龄的重要性，累积剂量,和肝脏疾病关于筛查时机和频率的建议。
