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Oral Montelukast Reduces Risk of Diabetic Retinopathy: ARVO 2021

Chronic inflammation and oxidative stress are critical components in the pathogenic cascade of early diabetic retinopathy, characterized by neuronal and vascular degeneration. In a recent study, researchers have found that oral montelukast decreases the odds of diabetic retinopathy (DR). The study findings were presented at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO) on May 2, 2021.
Recent research using experimental animal models has suggested that montelukast, a leukotriene receptor antagonist, may play a role in preventing diabetic retinopathy (DR). However, few studies have investigated its potential efficacy in humans. Therefore, researchers of the Byers Eye Institute at Stanford, USA, conducted a study to investigate whether the use of oral montelukast was associated with decreased odds of DR in patients with diabetes mellitus.
In this case-control study, the researchers used the Institutional Cohort Finder tool and assessed the medical records of subjects presenting to a tertiary eye centre between November 1, 2019, and November 1, 2020. They included a total of 563 patients among which 210 patients were cases who had diabetic retinopathy at presentation, and 353 patients were in the control group who had no DR. The researchers used the available clinical records and also assessed the patients for the presence of DR risk factors, including elevated haemoglobin (Hb)A1c levels, smoking history, end-organ damage (i.e. diabetic nephropathy and neuropathy), hypertension, hyperlipidemia, and non-Caucasian race.
Key findings of the study were:
- The researchers noted that montelukast had been used by 14 of the 210 (6.6%) cases, compared with 60 of 353 (16.9%) of the controls.
- Upon multivariate logistic regression analysis, they found that the use of oral montelukast was significantly associated with decreased odds of DR (adjusted OR: 0.32), as well as identification as a "never smoker" (adjusted OR: 0.49).
- They also found several other factors associated with increased odds of diabetic retinopathy included hypertension (P < .0001), hyperlipidemia (P < .0001), and higher haemoglobin (Hb) A1c levels (P < .0001).
The authors concluded, "Use of oral montelukast is associated with decreased odds of DR in patients with diabetes mellitus; subjects with DR are less likely to have consumed oral montelukast. Given the role of chronic inflammation in the pathophysiology of DR, these protective benefits may be related to montelukast's anti-inflammatory properties."
For further information:
https://arvo2021.arvo.org/meetings/virtual/tbStN9hhc9pe87xFx
Dr Kartikeya Kohli, Senior Consultant in Internal Medicine and specialist in Diabetes,Obesity and kidney diseases has done his DNB (Medicine), MRCP (UK). He has also obtained ECFMG Certification from USA in 2011. Also he has done his super-specialist training in Nephrology at IP Apollo Hospital. Dr Kohli is currently practicing as Consultant Internal Medicine at Sitaram Bhartia Institute of Science and Research and Apollo Clinic in East of Kailash. In the past, he has worked with several renowned hospitals in Delhi, including Apollo Hospital, Sir Ganga Ram Hospital & Fortis Vasant kunj. His additional academic qualifications include a PG Diploma in Clinical Endocrinology & Diabetes, Advanced Diabetes Care & Comorbidities, and Advanced Cardiology & ECG from the Royal College of Physicians. Dr Kohli has made significant contributions to medical academics and professional education. He has independently organised more than 100 Continuing Medical Education (CME) programmes and authored over 200 medical articles for various medical bulletins and healthcare portals, including Medical Dialogues.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

