Abstract
Abstract: :
Purpose: Basic research has shown that early processes in the development of age–related macular degeneration (ARM) are related to inflammation. The objective of the present study is to evaluate the association of ARM and the use of anti–inflammatory drugs. Methods: A nested case control study was carried among male patients at the Veteran’s Medical Center in Birmingham, Alabama (BVAMC). Cases were 551 patients with incident ARM diagnosed between 1997 and 2001 by ICD–9 code. Controls (n=5,500) were individuals with no diagnosis of ARM by ICD–9 coding. Controls were randomly selected from the study population and matched on age. Formulary records of all medications dispensed through the BVAMC were accessed. Each drug was individually reviewed for anti–inflammatory properties. All oral or injectable drugs with anti–inflammatory properties were considered anti–inflammatory drugs for study purposes. Topical ophthalmic and dermatologic preparations were not considered anti–inflammatory. Multivariate logistic regression analysis was done to evaluate the association of anti–inflammatory drug use and ARM controlling for age, diabetes, lipid metabolism, hypertension, cardiovascular disease, cerebrovascular disease, and arterial disease. Results: Overall individuals with an ARM diagnosis were 81% less likely to have filled a prescription for anti–inflammatory drugs (odds ratio [OR] 0.19, 95% confidence interval [CI] 0.15, 0.24). Both current users (OR 0.22, 95% CI 0.17, 0.29) and past users (OR 0.15, 95% CI 0.11, 0.21) of anti–inflammatory drugs had reduced risk of ARM. Those who had filled prescriptions for >24 months had a lower risk (OR 0.14, 95% CI 0.10, 0.20) than those who had filled prescriptions for 12–23 months (RR 0.24, 95% CI 0.16, 0.37). Conclusions: The results of this study suggest that veterans who had filled a prescription for anti–inflammatory medications had a reduced risk of ARM. Further studies are needed to confirm this result.
Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • drug toxicity/drug effects