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Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration.

Publication ,  Journal Article
Curtis, LH; Hammill, BG; Schulman, KA; Cousins, SW
Published in: Arch Ophthalmol
October 2010

OBJECTIVE: To examine associations between therapies for age-related macular degeneration and risks of all-cause mortality, incident myocardial infarction, bleeding, and incident stroke. METHODS: We conducted a retrospective cohort study of 146,942 Medicare beneficiaries 65 years or older with a claim for age-related macular degeneration between January 1, 2005, and December 31, 2006. On the basis of claims for the initial treatment, we assigned beneficiaries to 1 of 4 groups. The active control group included patients who received photodynamic therapy. The other groups included patients who received intravitreous pegaptanib octasodium, bevacizumab, or ranibizumab. We censored data from patients when they received a therapy different from the initial therapy. The main outcome measures were associations between photodynamic, pegaptanib, bevacizumab, and ranibizumab therapies and the risks of all-cause mortality, incident myocardial infarction, bleeding, and incident stroke. RESULTS: After adjustment for baseline characteristics and comorbid conditions, we found significant differences in the rates of mortality and myocardial infarction by treatment group. Specifically, the hazard of mortality was significantly lower with ranibizumab therapy than with photodynamic therapy (hazard ratio, 0.85; 99% confidence interval, 0.75-0.95) or pegaptanib use (0.84; 0.74-0.95), and the hazard of myocardial infarction was significantly lower with ranibizumab use than with photodynamic therapy (0.73; 0.58-0.92). There were no significant differences in the hazard of mortality or myocardial infarction between bevacizumab use and the other therapies. We found no statistically significant relationship between treatment group and bleeding events or stroke. CONCLUSION: Bevacizumab and ranibizumab use was not associated with increased risks of mortality, myocardial infarction, bleeding, or stroke compared with photodynamic therapy or pegaptanib use.

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Published In

Arch Ophthalmol

DOI

EISSN

1538-3601

Publication Date

October 2010

Volume

128

Issue

10

Start / End Page

1273 / 1279

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • United States
  • Stroke
  • Risk Factors
  • Retrospective Studies
  • Proportional Hazards Models
  • Photochemotherapy
  • Ophthalmology & Optometry
  • Myocardial Infarction
  • Medicare
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Curtis, L. H., Hammill, B. G., Schulman, K. A., & Cousins, S. W. (2010). Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration. Arch Ophthalmol, 128(10), 1273–1279. https://doi.org/10.1001/archophthalmol.2010.223
Curtis, Lesley H., Bradley G. Hammill, Kevin A. Schulman, and Scott W. Cousins. “Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration.Arch Ophthalmol 128, no. 10 (October 2010): 1273–79. https://doi.org/10.1001/archophthalmol.2010.223.
Curtis LH, Hammill BG, Schulman KA, Cousins SW. Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration. Arch Ophthalmol. 2010 Oct;128(10):1273–9.
Curtis, Lesley H., et al. “Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration.Arch Ophthalmol, vol. 128, no. 10, Oct. 2010, pp. 1273–79. Pubmed, doi:10.1001/archophthalmol.2010.223.
Curtis LH, Hammill BG, Schulman KA, Cousins SW. Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration. Arch Ophthalmol. 2010 Oct;128(10):1273–1279.

Published In

Arch Ophthalmol

DOI

EISSN

1538-3601

Publication Date

October 2010

Volume

128

Issue

10

Start / End Page

1273 / 1279

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • United States
  • Stroke
  • Risk Factors
  • Retrospective Studies
  • Proportional Hazards Models
  • Photochemotherapy
  • Ophthalmology & Optometry
  • Myocardial Infarction
  • Medicare