The authors evaluate the risk of non-infectious uveitis (NIU) in patients prescribed medications for medication-assisted treatment (MAT) of substance use disorders compared to a control group prescribed selective serotonin reuptake inhibitors (SSRIs). Utilising aggregated electronic health record data, this retrospective population-based cohort study analysed matched cohorts in 2 distinct settings: a low inflammatory risk setting excluding patients with systemic autoimmune or infectious risk factors, and a real-world setting reflecting a general population. Primary outcomes included the 30-, 90-, and 180-day post-prescription incidence of anterior, intermediate, posterior and pan-uveitis. In the low-risk analysis (42,559 matched pairs). MAT prescriptions were not associated with an increased risk of overall or subtype-specific NIU compared with SSRIs. Conversely, in the real-world analysis (84,091 matched pairs), MAT prescriptions demonstrated a statistically significant 44% higher risk of posterior NIU at 1 month (relative risk (RR) 1.44; 95% confidence interval (CI): 1.11–1.85), 3 months (RR 1.44; 95% CI: 1.14–1.83) and 6 months (RR 1.44; 95% CI: 1.16–1.80). Individual drug subgroup analyses revealed elevated risks associated with specific agents, such as baclofen. The authors conclude that MAT may subtly unmask or exacerbate posterior ocular inflammation in real-world populations with varied inflammatory backgrounds, supporting potential clinical benefits for routine ophthalmologic surveillance. Key limitations include reliance on administrative coding, unmeasured medication compliance or dosage parameters, and cohort aggregation required by data privacy constraints. Nevertheless, this study offers critical population-scale insight into drug-induced ocular inflammation, highlighting a novel safety parameter in substance use management.
Risk of non-infectious uveitis associated with medications for substance use disorders
Reviewed by Anitha Priya Arun Shankar
Risk of non-infectious uveitis associated with medications for substance use disorders.
