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The Association of Aspirin Use with Age-Related Macular Degeneration Progression in the Age-Related Eye Disease Studies: Age-Related Eye Disease Study 2 Report No. 20.
Ophthalmology ( IF 13.1 ) Pub Date : 2019-06-26 , DOI: 10.1016/j.ophtha.2019.06.023
Tiarnan D Keenan 1 , Henry E Wiley 1 , Elvira Agrón 1 , Mary E Aronow 1 , William G Christen 2 , Traci E Clemons 3 , Emily Y Chew 1 ,
Affiliation  

PURPOSE To analyze the potential association between aspirin use and progression of age-related macular degeneration (AMD). DESIGN Two prospective cohort studies within 2 controlled clinical trials of oral supplementation for age-related eye disease. PARTICIPANTS Age-Related Eye Disease Study (AREDS) participants 55 to 80 years of age and AREDS2 participants 50 to 85 years of age. METHODS Propensity scores for aspirin use were calculated for AREDS and AREDS2 participants separately by logistic regression. Of the participants without late AMD (geographic atrophy [GA] or neovascular AMD) in either eye at study baseline, aspirin users were matched 1:1 with nonusers by propensity score (separately for AREDS and AREDS2). Proportional hazards regression was performed, adjusting for age, on the matched participants to evaluate associations between aspirin propensity score and progression to late AMD (and its subtypes). MAIN OUTCOME MEASURES Progression to late AMD on color fundus photographs, graded centrally. RESULTS Of the 3734 eligible AREDS participants, 1049 (28.1%) were taking aspirin, and of the 2403 eligible AREDS2 participants, 1198 (49.9%) were taking aspirin. After matching by propensity score, the characteristics of the users and nonusers were similar in both studies. Of the 1950 matched AREDS participants and 1694 matched AREDS2 participants, over a median follow-up of 10.1 years and 5.0 years, respectively, the numbers who progressed to late AMD, GA, or neovascular AMD were 454 (23.3%), 345 (17.7%), and 278 (14.3%), respectively, in AREDS and 643 (38.0%), 402 (24.6%), and 341 (20.1%) in AREDS2. The hazard ratios of progression in quintile 5 (highest propensity for aspirin use) versus 1 (reference) were 1.17 (P = 0.35), 1.24 (0.25), and 0.95 (0.81), respectively, in AREDS and 1.26 (0.09), 1.46 (0.03), and 1.12 (0.58) in AREDS2. No significant association with progression to late AMD was observed for quintiles 2 through 5 for any of the 3 outcomes in either study. CONCLUSIONS Aspirin use was not associated significantly with progression to late AMD or its subtypes in either the AREDS or AREDS2. Patients with AMD need not avoid aspirin for this reason when its use is medically indicated.

中文翻译:

在与年龄有关的眼病研究中,阿司匹林的使用与与年龄有关的黄斑变性的进展相关:与年龄有关的眼病研究2报告第20号。

目的分析阿司匹林使用与年龄相关性黄斑变性(AMD)进展之间的潜在关联。设计两项前瞻性队列研究在2项针对年龄相关性眼部疾病的口服补充剂对照临床试验中进行。参与者年龄在55至80岁之间的年龄相关性眼病研究(AREDS)参与者和年龄在50至85岁之间的AREDS2参与者。方法通过逻辑回归分别计算AREDS和AREDS2参与者的阿司匹林使用倾向得分。在研究基线时,两只眼睛均无晚期AMD(地理萎缩[GA]或新生血管性AMD)的参与者中,阿司匹林使用者与倾向使用者的1:1得分与非使用者(分别针对AREDS和AREDS2)匹配。进行了比例风险回归,根据年龄进行了调整,对匹配的参与者进行评估,以评估阿司匹林倾向评分与晚期AMD(及其亚型)进展之间的关联。主要观察指标彩色眼底照片进展至晚期AMD,集中评分。结果在3734名合格的AREDS参与者中,有1049名(28.1%)正在服用阿司匹林,在2403名合格的AREDS2参与者中,有1198名(49.9%)正在服用阿司匹林。通过倾向得分匹配后,两项研究中使用者和非使用者的特征相似。在1950名匹配的AREDS参与者和1694名匹配的AREDS2参与者中,分别在中位随访时间10.1年和5.0年中,进展为晚期AMD,GA或新血管性AMD的人数分别为454(23.3%),345(17.7)在AREDS中分别为%)和278(14.3%),在AREDS2中分别为643(38.0%),402(24.6%)和341(20.1%)。在AREDS中,五分位数5(阿司匹林使用的最高倾向)与1(参考)的进展风险比分别为1.17(P = 0.35),1.24(0.25)和0.95(0.81),以及1.26(0.09),1.46 (0.03),以及AREDS2中的1.12(0.58)。在两项研究中,三分之二的结果中,第2至5分位数均未观察到进展至晚期AMD的显着关联。结论在AREDS或AREDS2中,阿司匹林的使用与晚期AMD或其亚型的进展没有显着相关。出于医学上的考虑,AMD患者不必因为这个原因而避免使用阿司匹林。在两项研究中,三分之二的结果中,第2至5分位数均未观察到进展至晚期AMD的显着相关性。结论在AREDS或AREDS2中,阿司匹林的使用与晚期AMD或其亚型的进展没有显着相关。出于医学上的考虑,AMD患者不必因为这个原因而避免使用阿司匹林。在两项研究中,三分之二的结果中,第2至5分位数均未观察到进展至晚期AMD的显着相关性。结论在AREDS或AREDS2中,阿司匹林的使用与晚期AMD或其亚型的进展没有显着相关。出于医学上的考虑,AMD患者不必因为这个原因而避免使用阿司匹林。
更新日期:2019-06-26
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