Low-Dose Aspirin fails to Effectively Prevent Age-Related Macular Degeneration: JAMA

A recent study published in the Journal of American Medical Association found that long-term low-dose aspirin use does not prevent the onset or progression of age-related macular degeneration (AMD) which is a leading cause of irreversible vision loss in the elderly. The ASPREE-AMD study was carried out to determine if daily low-dose aspirin could be an effective intervention against AMD. The recommendations for the participants at risk are generally limited to lifestyle, nutritional and supplement advice. This study explored whether aspirin could offer additional protective effects for vision health.

The ASPREE-AMD study was conducted across multiple centers in Australia as part of the international ASPREE trial examines the broader benefits of aspirin in prolonging disability-free survival among older individuals. The participants aged 70 and above who were free from dementia and significant physical disabilities, cardiovascular diseases or other chronic illnesses limiting five-year survival were included. The retinal images were taken at the start of the study between March 2010 and January 2015, and then again at three and five years post-randomization.

The study involved a total of 4,993 participants with 3,171 having complete data for analysis. The participants were randomly assigned to receive either 100 mg of enteric-coated aspirin daily or a placebo. The primary outcomes measured were the incidence of AMD and the progression from early or intermediate to late-stage AMD.

The results indicated no significant difference in AMD incidence between the aspirin and placebo groups. AMD developed in 19.4% of participants in the aspirin group when compared to 19.1% in the placebo group this also yielded a relative risk (RR) of 1.02 (95% CI, 0.85-1.22; P = .86). Also, the progression to late-stage AMD was observed in 2.3% of the aspirin group and 3.1% of the placebo group (RR, 0.72; 95% CI, 0.36-1.44; P = .36), suggesting a trend but not a statistically significant reduction in the progression.

The study concluded that low-dose aspirin that was taken over an average follow-up period of 3.1 years did not significantly impact the incidence or progression of AMD. The research also noted that while there was a slight indication of reduced progression to late-stage AMD in the aspirin group, the evidence was not strong enough due to the low number of cases observed.

Source:

Robman, L. D., Wolfe, R., Woods, R. L., Thao, L. T. P., Makeyeva, G. A., Hodgson, L. A. B., Lepham, Y.-A., Jachno, K., Phung, J., Maguire, E., Luong, H., Trevaks, R. E., Ward, S. A., Fitzgerald, S. M., Orchard, S. G., Lacaze, P., Storey, E., Abhayaratna, W. P., Nelson, M. R., … McNeil, J. J. (2024). Effect of Low-Dose Aspirin on the Course of Age-Related Macular Degeneration. In JAMA Ophthalmology. study's (AMA). https://doi.org/10.1001/jamaophthalmol.2024.1584