Do Aspirin and Other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Have a Protective Effect Against Neuro-Autoimmune Disease and Comorbidity?

Abstract

Objective To investigate the neuroprotective potential of Aspirin (AS) and other non-steroidal anti-inflammatory drugs (NSAIDs) against neuro-autoimmune diseases (NAD) and additional comorbidity. Background AS is an NSAID used for the treatment and prevention of cardiovascular and neurologic disease. However, the extent of Aspirin and other NSAIDs neuroprotective benefits and their prevention of additional comorbidity in patients with NAD has not been completely characterized. Design/Methods A retrospective analysis on 34464 patients hospitalized at a tertiary care center in a major metropolitan area was conducted. 6168 and 8228 patients were taking either AS or NSAIDs on admission, respectively. 18707 patients were not taking aspirin or NSAIDs (nMED). Patients with NAD were further categorized as taking Aspirin alone (aAS), taking NSAIDS alone (aNSAID), or no medications (anMED). The outcomes compared included the prevalence of NAD and risk of comorbidities. Results Patients taking AS or NSAID had no significant difference in NAD compared to those in nMED (0.45%, 0.6%, 0.56%, p > 0.05). Patients in aAS had a mortality rate at 10.7% compared to 1.9% in those in anMED (p < 0.05). 57% of aAS compared to 14.4% of anMED had high risk comorbidities (p < 0.0001). The prevalence of encephalopathy or overall neurological complications was significantly higher in aAS compared to anMED (17.8%, 6.7%, p > 0.05; 28.6%, 13.%, p > 0.05). Patients in aNSAID had no significant increase in mortality, high risk comorbidity, or overall neurological complications when compared with anMED (4%, 6.7%, p > 0.05; 10%, 6.7%, p > 0.05; 6.1%, 13.5%, p > 0.05). Conclusions These results suggest that AS may provide a strong protective benefit against neurological complications among those with NAD despite a significantly higher associated mortality and high risk comorbidity.