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No advantage of A beta 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies

Szekely, C A ; Green, R C ; Breitner, J C S ; Østbye, T ; Beiser, A S ; Corrada, M M ; Dodge, H H ; Ganguli, M ; Kawas, C H ; Kuller, L H ; Psaty, B M ; Resnick, S M ; Wolf, P A ; Zonderman, A B ; Welsh-Bohmer, K A ; Zandi, P P

Neurology, 2008-06, Vol.70 (24), p.2291-2298 [Periódico revisado por pares]

United States

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Título:
No advantage of A beta 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies
Autor: Szekely, C A ; Green, R C ; Breitner, J C S ; Østbye, T ; Beiser, A S ; Corrada, M M ; Dodge, H H ; Ganguli, M ; Kawas, C H ; Kuller, L H ; Psaty, B M ; Resnick, S M ; Wolf, P A ; Zonderman, A B ; Welsh-Bohmer, K A ; Zandi, P P
Assuntos: Acetaminophen - therapeutic use ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alzheimer Disease - prevention & control ; Amyloid beta-Peptides - metabolism ; Analgesics, Non-Narcotic - therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use ; Aspirin - therapeutic use ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Neuroprotective Agents - therapeutic use ; Peptide Fragments - metabolism ; Proportional Hazards Models ; Prospective Studies ; Risk Factors
É parte de: Neurology, 2008-06, Vol.70 (24), p.2291-2298
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Observational studies show reduced incidence of Alzheimer dementia (AD) in users of nonsteroidal anti-inflammatory drugs (NSAIDs). One hypothesis holds that the subset of NSAIDs known as selective A beta(42)-lowering agents (SALAs) is responsible for this apparent reduction in AD risk. We pooled individual-level data from six prospective studies to obtain a sufficient sample to examine AD risk in users of SALA vs non-SALA NSAIDs. Of 13,499 initially dementia-free participants (70,863 person-years), 820 developed incident AD. Users of NSAIDs (29.6%) showed reduced risk of AD (adjusted hazard ratio [aHR] 0.77, 95% CI 0.65-0.91). The point estimates were similar for SALAs (aHR 0.87, CI 0.72-1.04) and non-SALAs (aHR 0.75, CI 0.56-1.01). Because 573 NSAID users (14.5%) reported taking both a SALA and non-SALA, we examined their use alone and in combination. Resulting aHRs were 0.82 (CI 0.67-0.99) for SALA only, 0.60 (CI 0.40-0.90) for non-SALA only, and 0.87 (CI 0.57-1.33) for both NSAIDs (Wald test for differences, p = 0.32). The 40.7% of participants who used aspirin also showed reduced risk of AD, even when they used no other NSAIDs (aHR 0.78, CI 0.66-0.92). By contrast, there was no association with use of acetaminophen (aHR 0.93, CI 0.76-1.13). In this pooled dataset, nonsteroidal anti-inflammatory drug (NSAID) use reduced the risk of Alzheimer dementia (AD). However, there was no apparent advantage in AD risk reduction for the subset of NSAIDs shown to selectively lower A beta(42), suggesting that all conventional NSAIDs including aspirin have a similar protective effect in humans.
Editor: United States
Idioma: Inglês

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No advantage of A beta 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies

Szekely, C A ; Green, R C ; Breitner, J C S ; Østbye, T ; Beiser, A S ; Corrada, M M ; Dodge, H H ; Ganguli, M ; Kawas, C H ; Kuller, L H ; Psaty, B M ; Resnick, S M ; Wolf, P A ; Zonderman, A B ; Welsh-Bohmer, K A ; Zandi, P P

United States

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