Sildenafil flops in Reduction of Risk of Age-Related Macular Degeneration, suggests study

This study was published in BMC Open Ophthalmology by Han JED and colleagues. A retrospective matched open-cohort study analyzed data from the IQVIA Medical Research Data (IMRD-UK) primary care database, encompassing 307,384 male patients aged ≥40 years with ED. The study compared AMD incidence between sildenafil users (n = 31,575) and non-users (n = 62,155) over a 20-year period.

Key Findings:

• Among the study cohort, 234 sildenafil users and 398 non-users developed AMD during the follow-up period.

• After adjusting for confounders, including age, comorbidities, and socioeconomic factors, no significant difference in AMD incidence was observed between sildenafil users and non-users (adjusted hazard ratio [aHR], 0.99; 95% CI, 0.84 to 1.16).

• Subgroup analysis before the availability of over-the-counter sildenafil yielded similar results (aHR, 0.98; 95% CI, 0.83 to 1.15).

The study, led by Nicola Jaime Adderley, PhD, MPH, from the University of Birmingham, suggests that sildenafil use is unlikely to have a clinically meaningful preventive effect on AMD development. Despite prior hypotheses linking sildenafil to increased retinal blood flow and potential AMD prevention, real-world data did not support this notion.

Given the growing prevalence of AMD and the limited treatment options, understanding potential preventive measures is crucial. While sildenafil remains a widely used medication for ED, clinicians should not rely on it as a preventive strategy for AMD. Further research is needed to explore alternative preventive approaches and enhance AMD management strategies.

Reference:

Han JED, Subramanian A, Lee WH, et al Association of sildenafil use with age-related macular degeneration: a retrospective cohort study BMJ Open Ophthalmology 2024;9:e001525. doi: 10.1136/bmjophth-2023-001525