Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; Department of Ophthalmology, National Taiwan University Biomedical Park Hospital, Hsinchu, Taiwan.
J Formos Med Assoc. 2024 Apr;123(4):467-477. doi: 10.1016/j.jfma.2023.09.014. Epub 2023 Oct 17.
To analyze the associations between development of age-related macular degeneration (AMD) and regular use of aspirin or non-aspirin non-steroidal anti-inflammatory drugs (NA-NSAIDs).
We retrospectively recruited individuals who received ≥28-day prescriptions of aspirin or NA-NSAIDs exclusively between 2008 and 2017 in one tertiary center as regular users. Non-regular users were free from regular use of any anti-inflammatory drugs and were matched to regular users in terms of age, sex, and visit date at a ratio of 1-4:1. The aspirin cohort included 36,771 regular users and 110,808 matched non-regular users, while the NA-NSAID cohort included 59,569 regular users and 179,732 matched non-regular users. Stratified multivariate Cox regression analyses with adjustment for systemic confounding factors were performed for the development of AMD and neovascular AMD.
In the aspirin cohort, the adjusted hazard ratios of aspirin use for AMD in the whole cohort, individuals without cardiovascular diseases (CVDs), and those with CVDs were 0.664, 0.618, and 0.702, respectively (P < 0.0001 for all), while those of aspirin use for neovascular AMD were 0.486, 0.313, and 0.584 (P < 0.05 for all), respectively. In the NA-NSAID cohort, regular use of NA-NSAIDs was associated with a decreased risk of AMD (hazard ratio = 0.823, P < 0.0001) and neovascular AMD (hazard ratio = 0.720, P = 0.040) only in people without arthritis.
Regular use of aspirin or NA-NSAIDs had protective effects on AMD and neovascular AMD. The effect of aspirin was observed in all patients, while the effect of NA-NSAIDs was observed only in people without arthritis.
分析年龄相关性黄斑变性（AMD）的发展与阿司匹林或非阿司匹林非甾体抗炎药（NA-NSAIDs）的常规使用之间的关联。
我们回顾性招募了 2008 年至 2017 年期间在一家三级中心接受≥28 天阿司匹林或 NA-NSAIDs 处方的患者作为常规使用者。非常规使用者不常规使用任何抗炎药物，并根据年龄、性别和就诊日期与常规使用者以 1:4 的比例进行匹配。阿司匹林队列包括 36771 名常规使用者和 110808 名匹配的非常规使用者，而 NA-NSAID 队列包括 59569 名常规使用者和 179732 名匹配的非常规使用者。对 AMD 和新生血管性 AMD 的发生进行了分层多变量 Cox 回归分析，并调整了系统混杂因素。
在阿司匹林队列中，整个队列、无心血管疾病（CVDs）的个体和有 CVDs 的个体中阿司匹林使用的调整后 AMD 发生的风险比分别为 0.664、0.618 和 0.702（所有 P<0.0001），而阿司匹林使用的新生血管性 AMD 的风险比分别为 0.486、0.313 和 0.584（所有 P<0.05）。在 NA-NSAID 队列中，NA-NSAID 的常规使用与 AMD（风险比=0.823，P<0.0001）和新生血管性 AMD（风险比=0.720，P=0.040）的风险降低相关，仅在无关节炎的人群中。
常规使用阿司匹林或 NA-NSAIDs 对 AMD 和新生血管性 AMD 有保护作用。阿司匹林的作用在所有患者中均可见，而 NA-NSAIDs 的作用仅在无关节炎的人群中可见。
