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Aspirin safe to use in patients with age-related eye disease

09 Dec 2019
For nearly 100 years, aspirin has been a common drug used for pain relief and fever treatment.

Aspirin use does not appear to result in progression of age-related macular degeneration (AMD) or its subtypes in either the Age-Related Eye Disease Study (AREDS) or AREDS2, a study has shown. Thus, there is no need to avoid aspirin use when it is medically indicated in AMD patients.

Of the 3,734 and 2,403 eligible participants in AREDS and AREDS2, respectively, 1,049 (28.1 percent) and 1,198 (49.9 percent) were on aspirin. The characteristics of users and nonusers were similar in both studies after propensity-score matching.

Over a median follow-up of 10.1 years, 454 (23.3 percent), 345 (17.7 percent) and 278 (14.3 percent) of the 1,950 matched participants in AREDS progressed to late AMD, geographic atrophy (GA) or neovascular AMD, respectively. In AREDS2, 643 (38.0 percent), 402 (24.6 percent) and 341 (20.1 percent) of the 1,694 matched participants progressed to late AMD, GA or neovascular AMD, respectively, over a median follow-up of 5.0 years.

The corresponding hazard ratios of progression in quintile 5 (highest propensity for aspirin use) vs 1 (reference) were 1.17 (p=0.35), 1.24 (0.25) and 0.95 (0.81) in AREDS and 1.26 (p=0.09), 1.46 (p=0.03) and 1.12 (p=0.58) in AREDS2. No significant association with progression to late AMD was seen for quintile 2–5 for any of these outcomes in either study.

The investigators conducted two prospective cohort studies within two controlled clinical trials of oral supplementation for age-related eye disease and used logistic regression to calculate propensity scores for aspirin use for AREDS and AREDS2 participants separately.

Aspirin users without late AMD in either eye at study baseline were matched 1:1 with nonusers by propensity score. Associations between aspirin propensity score and progression to late AMD and its subtypes were assessed using proportional hazards regression, adjusting for age.

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