Association between ophthalmic timolol and hospitalisation for bradycardia
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(Published version)
Date
2015
Authors
Pratt, N.L.
Ramsay, E.N.
Kalisch Ellett, L.M.
Nguyen, T.A.
Roughead, E.E.
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Journal article
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Journal of Ophthalmology, 2015; 2015(article no. 567387):1-6
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Abstract
Introduction: Topical non-selective beta-blockers for glaucoma have the potential to be absorbed systemically which may cause adverse cardiovascular effects. The aim of this study was todetermine whether initiation of topical non-selective beta-blockers is associated with an increased risk of hospitalisation for bradycardia.
Conclusion: Bradycardia is a potential adverse event following timolol initiation. Practitioners should be reminded to carefully examine the patient history before choosing a glaucoma regime and closely monitor patients after treatment initiation with topical non-selective beta-blocker eye drops.
Materials and methods: A self-controlled case-series study was undertaken in patients who were hospitalised for bradycardia and were exposed to timolol during the study period. Person time after timolol initiation was partitioned into the following risk periods: 1-30 days, 31-180 days, and >180 days. A risk period of 30 days prior to initiating treatment with timolol was also included to ensure the outcome was not altering the probability of subsequent exposure. All remaining time was considered unexposed.
Results: There were 6,373 veterans with at least one hospitalisation for bradycardia during the study period, 267 exposed to timolol.The risk was not statistically significantly elevated in the first 30 days after initiating timolol (Incidence Rate Ratio [IRR] = 1.40 (95% Confidence Interval [CI] 0.87 - 2.26), but was significantly increased in the 31-180 day risk period (IRR = 1.93; 95% CI 1.00-2.87). The elevated risk was not observed beyond 180 days. (IRR 1.21; 95% CI 0.64 - 2.31)
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Copyright 2014 The Authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (https://creativecommons.org/licenses/by/3.0/)