Statins are a widely used class of medications that lower cholesterol levels in patients with hyperlipidemia. Recent evidence suggests that statins can also reduce the risk for cerebrovascular and cardiovascular events and may be helpful in diseases of the central nervous system, including ischemic stroke, Alzheimer disease, and multiple sclerosis. Growing evidence suggests that statin drugs may also protect against worsening of OAG, one of the most common causes of blindness worldwide. Basic scientists have identified several mechanisms by which statins may protect against OAG progression-for example, by improving blood flow to the optic nerve as a result of upregulating endothelial nitric oxide synthase, and by enhancing aqueous outflow through the inhibition of Rho kinase activity. Several cohort and case-control studies have demonstrated reduced rates of OAG or disease stabilization among statin users. In preliminary analyses, we analyzed longitudinal data on a group of 524,109 enrollees, aged 60 years or older, with hyperlipidemia in a large, nationwide, managed-care network and found that persons using a statin agent had a significantly reduced risk for developing OAG and for progressing from suspected glaucoma to OAG, compared with persons who were not using statin drugs.
The aim of this R34 clinical trial planning grant is to assemble the necessary infrastructure to carry out a large, multicenter, double-masked, RCT to determine whether statins play a protective role against OAG progression in persons with mild or moderate OAG. An RCT demonstrating that statins protect against worsening of glaucoma would have important clinical implications for patient care, as it would provide an evidence basis for protecting patients from disease progression in this potentially blinding disease by using a commonly available medication for a new indication.
This study is designed to determine whether medications that are used to treat high cholesterol called statins are protective against glaucoma progression. The discovery of a new approach to treat glaucoma, a disease that causes loss of peripheral vision and blindness, would substantially impact human health through reducing the burden of visual disability in a world where more than 60 million individuals are now blind from glaucoma.
|Talwar, Nidhi; Musch, David C; Stein, Joshua D (2017) Association of Daily Dosage and Type of Statin Agent With Risk of Open-Angle Glaucoma. JAMA Ophthalmol 135:263-267|
|Musch, David C; Gillespie, Brenda W; Palmberg, Paul F et al. (2014) Visual field improvement in the collaborative initial glaucoma treatment study. Am J Ophthalmol 158:96-104.e2|