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Does Dexamethasone Cause Cataracts?
Posted: Nov 14, 2023
Does Dexamethasone Cause Cataracts?  image

At the 20th Annual International Myeloma Society meeting in Athens, Greece, Dr. Rahul Banerjee shared his research on the connection between dexamethasone treatment and cataracts within the myeloma patient population. 

Dexamethasone and Multiple Myeloma 

Dr. Banerjee is an assistant professor of medicine at the Fred Hutchinson Research Center in Seattle, Washington. He collaborated with the research team at the HealthTree Foundation to study ocular health (specifically cataracts) within multiple myeloma patients and what link the corticosteroid dexamethasone plays. 

This topic isn't new to Dr. Banerjee, who gave an excellent presentation on dexamethasone to the Newly Diagnosed Myeloma Community that you can read more about here:Dexamethasone: The Myeloma Hero or Villain?

Specialists are aware that dexamethasone is not one of their patient's favorite medicine. This can be due to many factors, but especially due to the unwanted side effects of dexamethasone that can appear as: 

  • insomnia 
  • anxiety 
  • high blood sugar 
  • intense mood swings 
  • and more 

A lot of these side effects can be recognized and seen by myeloma caregivers, patients, and care teams quickly, but Dr. Banerjee recognized other side effects that were going unnoticed for long periods of time within his clinic. 

Why Study Eye Health and Dexamethasone in Myeloma Treatment? 

He frequently heard his patients mention that they needed to get a new glasses prescription, that they couldn't drive as easily as before, or that their vision would get blurry. Dr. Banerjee began to wonder why these would frequently happen in the midst of myeloma therapy and hypothesized that perhaps dexamethasone could be the culprit behind the degenerative ocular health. 

"Thank you to all the patients participating in HealthTree Cure Hub," Dr. Banerjee shares, "we looked at over 200+ myeloma patients' anonymized data who had reported some ocular health issues such as cataracts. We examined their anonymized EHR (electronic health records) and patient history to get a full picture of the data."     

Conclusions

Dr. Banerjee and the HealthTree Research Team found that cataracts were very common in the myeloma population, with around 250 people reporting cataracts. The likelihood of a myeloma patient getting cataracts increases with time. While this could be due to "old age," the team decided to delve a little deeper. 

Among patients who developed cataracts after starting myeloma treatments (which almost always include steroids at induction), about a third of patients reported cataracts within six months of induction; by twelve months post-induction, that number was up to 48%. This means almost half of myeloma patients who are going to get cataracts during the myeloma journey do so within their first year of treatment. 

Further findings included a clear link between serious cataracts and the duration (longitudinal lifetime exposure) and dose of dexamethasone. They analyzed 100 patients' anonymized data to determine the quantity of steroids down to the milligrams that they had received throughout their myeloma journey. 

In easier-to-understand terms, patients who reported cataracts being very significant (affecting their quality of life, disrupting their activities of daily living) had almost two-and-a-half more times the amount of lifetime steroids than those who reported more minor cataracts. 

Interestingly enough, it wasn't the time of exposure to steroids alone that determined the severity of the cataracts, rather, it was a combination of both the duration and the dose of steroids. 

When commenting on the findings, Dr. Banerjee shared, 

"What this means to me is that it's not just that patients are getting older, and if you get older, you start to get more cataracts. There's something about dexamethasone (often 40 milligrams weekly, 20 milligrams twice weekly) that seems to be doing this." 

Based on the results of this initial survey, Dr. Banerjee and his research team are collaborating again with HealthTree to develop a new ocular eye health study to ask both precursor and active myeloma patients about their eye health (blurry vision, cataracts, glaucoma), how often they see their eye doctor, and more to better assess and understand these findings. 

If you would like to participate in this key research study and help researchers discover "more than meets the eye", see the section below. 

How You Can Help 

You can contribute to myeloma research like Dr. Banerjee's by creating or updating your HealthTree Cure Hub account today. It's easier than ever! Click here: HealthTree Cure Hub Account 

As mentioned earlier, you can participate in the follow-up study of Dr. Banerjee on Ocular Health today after creating a quick HealthTree Cure Hub account (or login into your existing account): Ocular (Eye) Health Study with HealthTree

Please note: If you are a myeloma patient who has been on any myeloma therapy and has NOT developed eye issues, we strongly encourage you to take this survey as we need a strong subset of patients to compare in order to confirm our findings. 

Remember, when specialists see "your" data for research purposes, it's always anonymized. We respect your privacy and value your contribution to accelerating myeloma research by sharing your story through your data.

Resources

To see more IMS 2023 Videos, check out HealthTree University: IMS HTU Courses

This abstract was published in American Journal of Hematology: Association between dexamethasone exposure and visually significant cataracts in multiple myeloma

Check out this publication and more HealthTree myeloma research on our website: HealthTree Research Publications 

The author Audrey Burton-Bethke

about the author
Audrey Burton-Bethke

Audrey is the Editor for the HealthTree Foundation for Multiple Myeloma. She originally joined the HealthTree Foundation in 2020 as the Myeloma Community Program Director. While not knowing much about myeloma initially, she worked hard to educate herself, empathize and learn from others' experiences. She loves this job. Audrey is passionate about serving others, loves learning, and enjoys iced chais from Dutch Bros. She also loves spending time with her supportive husband and energetic three-year-old. 

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