Ocular Adverse Events Related to Taxane-Based Drugs
By Jean Shaw
Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
Journal Highlights
JAMA Ophthalmology, September 2022
Download PDF
Sodhi et al. quantified the risk of three mutually exclusive ocular adverse events—epiphora, cystoid macular edema (CME), and optic neuropathy—with the use of docetaxel and paclitaxel. They found that these taxane-based drugs, which are used to treat women with breast cancer, were associated with an elevated risk of these adverse outcomes.
For this retrospective cohort study, the researchers used the PharMetrics Plus database, which captures information from more than 150 million enrollees in the United States. They created a cohort of women who were new users of taxanes and a control group of women who were new users of tamoxifen. (Tamoxifen was chosen as the reference drug because its method of action is different than that of taxanes.)
Results were as follows:
- Epiphora: The incidence was 55.6 per 10,000 person-years among taxane users, versus 7.9/10,000 for those taking tamoxifen. The adjusted hazard ratio (HR) was 5.15 (95% confidence interval [CI], 2.79-9.54). Of note, this category included stenosis of lacrimal canaliculi and obstruction of nasolacrimal ducts.
- CME: The incidence was 34.8/10,000 person-years for those taking a taxane, versus 16.8/10,000 person-years for those on tamoxifen. The adjusted HR was 1.33 (95% CI, .70-2.53).
- Optic neuropathy: The incidence was 10.6/10,000 person-years for taxane users, versus 1.2/10,000 person-years for those taking tamoxifen. The adjusted HR was 4.44 (95% CI, 1.04-18.87). Of note, this category included both ischemic optic neuropathy and toxic optic neuropathy.
The researchers urge awareness of the potential for ocular adverse effects secondary to taxane-based chemotherapeutics, as early treatment may prevent complications and improve outcomes.
The original article can be found here.