Association of interleukin-6 pathway inhibition with risk of age-related macular degeneration: A propensity-matched cohort study

PurposeTo evaluate the association between systemic tocilizumab exposure and the development of age-related macular degeneration (AMD) in a large real-world cohort.MethodsThis was a retrospective, propensity-matched cohort study including patients aged ≥40 years in the TriNetX Research Network with or without exposure to tocilizumab between May 2008 and May 2025. Patients with documented tocilizumab use were matched 1:1 to controls based on demographic and clinical characteristics within the TriNetX platform. Individuals with prior AMD were excluded from incident analyses. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated for incident non-exudative and exudative AMD.ResultsAfter propensity score matching, 23,456 patients were included per group. Tocilizumab use was associated with a significantly lower risk of incident non-exudative AMD (RR, 0.282; 95% CI, 0.230-0.346; p < 0.001) and incident exudative AMD (RR, 0.234; 95% CI, 0.159-0.344; p < 0.001) compared with matched controls.ConclusionsSystemic tocilizumab exposure was associated with a lower incidence of both non-exudative and exudative AMD in this real-world cohort. These findings should be considered hypothesis-generating and support further study of the relationship between IL-6 signaling and AMD.