Abstract
BackgroundThe association of aspirin use and nonsteroid anti-inflammatory drug (NSAID) use with amyotrophic lateral sclerosis (ALS) risk is unclear. This study determined whether use of any individual compound is associated with ALS risk by conducting a total population-based case-control study in Taiwan.MethodsA total of 729 patients with newly diagnosed ALS who had a severely disabling disease certificate between January 1, 2002, and December 1, 2008, comprised the case group. These cases were compared with 7290 sex-, age-, residence-, and insurance premium-matched controls. Drug use by each Anatomical Therapeutic Chemical code was analyzed using conditional logistic regression models. False discovery rate (FDR)-adjusted P values were reported in order to avoid inflating false positives.ResultsOf the 1336 compounds, only the 266 with use cases exceeding 30 in our database were included in the screening analysis. Without controlling for steroid use, the analysis failed to reveal any compound that was inversely associated with ALS risk according to FDR criteria. After controlling for steroid use, we found use of the following compounds to be associated with ALS risk: aspirin, diphenhydramine (one of the antihistamines), and mefenamic acid (one of the NSAIDs). A multivariate analysis revealed that aspirin was independently inversely associated with ALS risk after controlling for diphenhydramine, mefenamic acid, and steroid use. The inverse association between aspirin and ALS was present predominately in patients older than 55 years.ConclusionsThe results of this study suggested that aspirin use might reduce the risk of ALS, and the benefit might be more prominent for older people.
Highlights
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease
Prescriptions for individual compounds were double-checked by a physician and a pharmacist, and the National Health Insurance (NHI) covered almost all residences; any information bias related to prescribed compounds should be minimal
This study is the first to screen the association between individual prescription compounds and amyotrophic lateral sclerosis (ALS) risk in a population-based study
Summary
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Without mechanical ventilation, death resulting from respiratory failure typically follows within 2 to 5 years of the onset of symptoms.[1]. Methods: A total of 729 patients with newly diagnosed ALS who had a severely disabling disease certificate between January 1, 2002, and December 1, 2008, comprised the case group. These cases were compared with 7290 sex-, age-, residence-, and insurance premium-matched controls. Without controlling for steroid use, the analysis failed to reveal any compound that was inversely associated with ALS risk according to FDR criteria. After controlling for steroid use, we found use of the following compounds to be associated with ALS risk: aspirin, diphenhydramine (one of the antihistamines), and mefenamic acid (one of the NSAIDs). A multivariate analysis revealed that aspirin was independently inversely associated with ALS risk after controlling for diphenhydramine, mefenamic acid, and steroid use. Conclusions: The results of this study suggested that aspirin use might reduce the risk of ALS, and the benefit might be more prominent for older people
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