Glaucoma Risk of Serotonin-norepinephrine Reuptake Inhibitors (SNRIs) and Gabapentinoids in Fibromyalgia Patients

Abstract Objectives To evaluate the association between glaucoma risk and the use of serotonin-norepinephrine reuptake inhibitors (SNRIs) and gabapentinoids in patients with fibromyalgia (FM). Methods We conducted this retrospective cohort study by utilizing the US Collaborative Network from TriNetX database, and included newly diagnosed FM patients, categorizing them into four groups based on SNRI and gabapentinoid prescriptions. Glaucoma was set as the primary outcome, with angle-closure and open-angle subtypes being secondary outcomes in 3-year follow-up. Kaplan-Meier analyses with Cox proportional hazard model and 1:1 propensity-score matching were performed for risk comparisons. Results After propensity-score matching, we identified 37354 and 47308 patients respectively in each SNRI-related and gabapentinoid-related cohort, most of whom were White females. There was an association between the use of SNRIs [hazard ratio (HR) = 1.458, 95% confidence interval (CI): 1.184 – 1.796] and gabapentinoids (HR = 1.579, 95% CI: 1.318 – 1.892), and increased glaucoma risk compared to non-users. Additionally, SNRI users exhibited a higher glaucoma risk than gabapentinoid users (HR = 1.354, 95% CI: 1.031 – 1.777). Conclusion SNRIs and gabapentinoids increase the glaucoma risk in FM patients, with SNRI users exhibiting higher glaucoma risk than the gabapentinoid users.