Purpose

To date, population-based studies reporting associations between dry eye disease and medications were hypothesis-driven, did not take into account underlying comorbidities, and did not investigate individual drugs. The purpose of this study was to clarify the association of dry eye symptoms with medication classes and individual drugs, using a hypothesis-free approach.

Methods

79,606 participants (age 20–97 years, 59.2% female) from the population-based Lifelines cohort in the Netherlands were cross-sectionally assessed for dry eye symptoms using the Womens’ Health Study dry eye questionnaire. All medications used were coded with the ATC classification system. Logistic regression was used to assess the risk of the 59 most-used therapeutic/pharmacological subgroups and the 99 most-used individual drugs (all n > 200) on dry eye symptoms, correcting for age, sex, body mass index, and 48 comorbidities associated with dry eye.

Results

Thirty-eight (64%) medication subgroups and fifty-two (53%) individual drugs were associated with dry eye symptoms (P < 0.05), after correction for age and sex only. A multivariable model correcting for comorbidities revealed highly significant associations between dry eye symptoms and drugs for peptic ulcer (particularly proton pump inhibitors (PPIs)), antiglaucoma and anticholinergic medications.

Conclusions

This study underlines that medication use is highly informative of risk of dry eye symptoms. Correction for underlying comorbidities is critical to avoid confounding effects. This study confirms suggested associations between medications and dry eye symptoms at a population level and shows several new associations. The novel link between PPIs and dry eye symptoms deserves particular attention given how commonly they are prescribed.

中文翻译：

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药物使用和干眼症状：荷兰一项大型、无假设、基于人群的研究

目的

迄今为止，报告干眼病与药物之间关联的基于人群的研究是假设驱动的，没有考虑潜在的合并症，也没有调查个别药物。本研究的目的是使用无假设的方法阐明干眼症症状与药物类别和个别药物的关联。

方法

来自荷兰基于人群的生命线队列的 79,606 名参与者（年龄 20-97 岁，59.2% 为女性）使用女性健康研究干眼问卷调查问卷对干眼症状进行了横断面评估。所有使用的药物均使用 ATC 分类系统进行编码。Logistic 回归用于评估 59 个最常用的治疗/药理学亚组和 99 个最常用的单个药物（所有 n > 200）对干眼症状的风险，校正年龄、性别、体重指数和 48 种合并症与干眼症有关。

结果

仅校正年龄和性别后，三十八 (64%) 个药物亚组和五十二 (53%) 种药物与干眼症状相关 (P < 0.05)。校正合并症的多变量模型显示干眼症状与消化性溃疡药物（特别是质子泵抑制剂 (PPI)）、抗青光眼和抗胆碱能药物之间存在高度显着的关联。

结论

该研究强调，药物使用对干眼症状的风险具有重要意义。纠正潜在的合并症对于避免混淆效应至关重要。这项研究证实了在人群水平上药物与干眼症状之间的建议关联，并显示了几个新的关联。考虑到 PPI 和干眼症状之间的新联系，它们被广泛使用，值得特别关注。