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

Szekely, CA ; Green, R C ; Breitner, JCS ; Oestbye, T ; Beiser, A S ; Corrada, M M ; Dodge, H H ; Ganguli, M ; Kawas, CH ; Kuller, L H ; Psaty, B M ; Resnick, S M ; Wolf, P A ; Zandi, P P

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

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  • Título:
    No advantage of A beta sub(42)-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies
  • Autor: Szekely, CA ; Green, R C ; Breitner, JCS ; Oestbye, T ; Beiser, A S ; Corrada, M M ; Dodge, H H ; Ganguli, M ; Kawas, CH ; Kuller, L H ; Psaty, B M ; Resnick, S M ; Wolf, P A ; Zandi, P P
  • É parte de: Neurology, 2008-06, Vol.70 (24), p.2291-2298
  • Notas: ObjectType-Article-2
    SourceType-Scholarly Journals-1
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    ObjectType-Feature-1
  • Descrição: Introduction: 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 AP42-lowering agents (SALAs) is responsible for this apparent reduction in AD risk. Methods: 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. Results: 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). Conclusions: 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 sub(42), suggesting that all conventional NSAIDs including aspirin have a similar protective effect in humans.
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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