Highlights
- •Statins and/or proprotein convertase subtilisin/kexin type 9 antibodies do not increase or decrease the rate of cataract.
- •No difference of statin vs proprotein convertase subtilisin/kexin type 9 treatment with respect to cataract was seen.
- •Very low levels of low-density lipoprotein cholesterol are not associated with the development of cataract.
- •Fear of cataract should not prevent the use of cholesterol-lowering therapy.
Background
It is not known whether statins or proprotein convertase subtilisin/kexin type 9 (PCSK9)
antibodies are associated with cataract and whether very low achieved low-density
lipoprotein cholesterol (LDL-C) lowering may cause cataract.
Objective
To examine two questions: whether statins and/or PCSK9 antibodies cause or prevent
cataracts and whether very low LDL-C is associated with increased risk of cataract.
Methods
Systematic searches of PubMed, ClinicalTrials.gov, Web of Science, The Cochrane Library, and an Federal Drug Administration report
were used to perform random effects meta-analyses on the relationship of statins and/or
PCSK9 antibodies with cataract. These meta-analyses were performed according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
Results
Prespecified analyses indicated no significant effect of statins or PCSK9 antibodies
(odds ratio [OR] 0.99, 95% confidence interval [CI] 0.83–1.17, P = .8889) or differences between the effects of statins (OR 0.89, 95% CI 0.66–1.19,
P = .4349) and PCSK9 antibodies (OR 1.04, 95% CI 0.85–1.28, P = .7042) on the development of cataract. Also, there was no significant effect of
LDL-C lowering to different levels with respect to cataract (OR 1.06, 95% CI 0.92–1.22,
P = .4317). Meta-regression of the log OR for cataract vs LDL-C during treatment did
not show a statistically significant relationship (P for slope = .3972).
Conclusion
There was no significant effect of cholesterol lowering with statins or PCSK9 antibodies
or differences between these two medication classes in causing or preventing cataracts.
However, it is difficult to make definitive statements regarding PCSK9 antibodies
because there is no long-term experience with these agents. Very low LDL-C was not
associated with higher risk of cataract.
Keywords
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Article info
Publication history
Published online: February 08, 2018
Accepted:
February 2,
2018
Received:
December 13,
2017
Identification
Copyright
© 2018 National Lipid Association. All rights reserved.
