Angiotensin Converting Enzyme-Inhibitors and Incidence of Non-infectious Uveitis in a Large Healthcare Claims Database

ABSTRACT

Purpose

To determine if angiotensin converting enzyme-inhibitors (ACE-I) alter the incidence of non-infectious uveitis (NIU).

Methods

Patients in a large healthcare claims database who initiated ACE-I (n = 695,557) were compared to patients who initiated angiotensin receptor blockers (ARB, n = 354,295). A second comparison was also made between patients who initiated ACE-I (n = 505,958) and those who initiated beta-blockers (BB, n = 538,109). The primary outcome was incident NIU defined as a first diagnosis code for NIU followed by a second instance of a NIU code within 120 days. For the secondary outcome, a corticosteroid prescription or code for an ocular corticosteroid injection within 120 days of the NIU diagnosis code was used instead of the second NIU diagnosis code. Data were analyzed using Cox regression modeling with inverse probability of treatment weighting (IPTW). Sub-analyses were performed by anatomic subtype.

Results

When comparing ACE-I to ARB initiators, the hazard ratio (HR) for incident NIU was not significantly different for the primary outcome [HR = 0.95, 95% Confidence Interval (CI): 0.85–1.07, P = .41] or secondary outcome [HR = 0.96, 95% CI: 0.86–1.07, P = .44]. Similarly, in the ACE-I and BB initiators comparison, the HR for incident NIU was not significantly different comparing ACE-I and BB initiators for either outcome definition or any of the NIU anatomical subtypes.

Conclusion

Our results suggest there is no evidence that ACE-I have a protective effect on NIU.

KEYWORDS:

• Non-infectious uveitis
• ACE-inhibitors
• epidemiology
• big data
• incidence

Disclosure statement

Dr. Kempen has served as a consultant for Gilead (Data and Safety Monitoring Committee Chair). Dr. Hubbard has received financial support from Pfizer and Humana. The remaining authors have no conflicts of interest to disclose.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was funded by two National Institutes of Health grants: R21 EY029851 and the University of Pennsylvania Core Grant for Vision Research, P30 EY001583.