NSAID use and the risk of AMD: Insights From a Multi-Center Cohort Analysis.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 42070633.
- Also identified by DOI 10.1016/j.ophtha.2026.04.027.
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Abstract
The purpose of this study was to investigate the effect of NSAID use and the risk of AMD. This retrospective cohort study utilized deidentified multi-center electronic medical records database. This study included patients who received prescriptions for NSAIDs and individuals who never received prescriptions for NSAIDs in order to assess for the effects of NSAIDs prescriptions on future AMD risk. Data from the TriNetX database between January 1st, 2015, and December 31st, 2024 were used to identify patients who were prescribed NSAIDS with no prior history of AMD. The NSAID patient cohort was propensity score-matched in a 1:1 ratio with a control group of randomly selected patients without a history of NSAID use, based on age, sex, race, and selected comorbidities of interest, including smoking and other common adult comorbidities that could potentially affect future AMD risk. Cumulative incidence and hazard ratio of AMD. 634,794 patients who were prescribed NSAIDs (mean age 59.93 ± 11.95 years) and 634,794 patients who weren't prescribed NSAIDs (mean age 59.68 ± 12.15 years) were recruited. Among NSAID users, decreased risk for AMD development was seen at the 6-month (HR: 0.31, CI: 0.27-0.36), 1-year (HR: 0.36, CI: 0.33-0.39), 3-year (HR: 0.42, CI: 0.40-0.44), and 5 years (HR: 0.48, CI: 0.47-0.50) time point after the index date for NSAID use compared to non-NSAID users. A protective effect against AMD development was also observed throughout the entire study duration (HR: 0.58, CI: 0.56-0.59) among NSAID users compared to non-NSAID users. A protective effect against AMD development was also observed during the study duration among patients who were prescribed aspirin (HR: 0.72; 95% CI: 0.69-0.75) and those prescribed non-selective COX-2 inhibitors (HR: 0.41; 95% CI: 0.36-0.46) compared to their respective non-users. A decreased risk for AMD was also observed for both non-exudative (HR: 0.56, CI: 0.55-0.58) and exudative (HR: 0.62, CI: 0.59-0.65) AMD subtypes after index NSAID prescription compared to non-users. A protective effect against future AMD development was suggested among patients prescribed NSAIDs compared to non-users.