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Mary E Aronow, Michael L Klein, Traci E Clemons, Frederick L Ferris, Elvira Agron, Barbara A Blodi, Emily Y Chew, ; Effect of Aspirin Use on Progression of Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2 (AREDS2) Participants. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2993.
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To determine whether aspirin use is associated with the progression of age-related macular degeneration (AMD).
Participants aged 50 to 85 years, with no geographic atrophy or neovascularization at baseline (N = 2442) enrolled in the Age-Related Eye Disease Study 2 (AREDS2), a multicenter, phase 3, randomized, controlled clinical trial were analyzed. In order to reduce bias from confounding variables, propensity scoring was used to match aspirin users, defined as those individuals taking aspirin at least five times per week, to non-aspirin users. The propensity score for aspirin use was generated using a logistic regression model of baseline characteristics (age, sex, race, education, smoking history, hypertension, diabetes, and angina). Matching participants based upon propensity scores yielded 957 aspirin users and 957 non-aspirin users (N = 1914). Progression of AMD was defined as development of either any geographic atrophy or neovascularization during the study period (2006 - 2012). Proportional hazards regression, adjusted for propensity score and age, was used to evaluate the association between aspirin use and AMD progression.
Aspirin propensity score adjusted for age, was not associated with AMD progression (odds ratio [OR] =0.80, 95% confidence interval [CI] =0.41-1.56, P = 0.5076). When outcomes were analyzed individually, neither geographic atrophy (OR =1.31, 95% CI =0.52-3.32, P = 0.5688) nor neovascularization (OR =0.60, 95% CI = 0.23-1.58, P =0.3049) was associated with the aspirin propensity score.
Contrary to previous reports of association of aspirin use with advanced AMD, especially neovascular AMD, observational data from the AREDS2 suggest that the use of aspirin has no statistically significant association with AMD progression. We can reassure our patients with AMD that aspirin could be considered when medically indicated.
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