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Observational Study
. 2024 Feb 1;142(2):108-114.
doi: 10.1001/jamaophthalmol.2023.6014.

Alzheimer Disease Treatment With Acetylcholinesterase Inhibitors and Incident Age-Related Macular Degeneration

S Scott Sutton  1   2 , Joseph Magagnoli  1   2 , Tammy H Cummings  1   2 , James W Hardin  1   3 , Jayakrishna Ambati  4   5   6   7
Affiliations
Observational Study

Alzheimer Disease Treatment With Acetylcholinesterase Inhibitors and Incident Age-Related Macular Degeneration

S Scott Sutton et al. JAMA Ophthalmol. .

Abstract

Importance: Age-related macular degeneration (AMD) is a serious and common ophthalmologic disorder that is hypothesized to result, in part, from inflammatory reactions in the macula. Alzheimer disease (AD) treatment, acetylcholinesterase inhibitors (AChEIs), have anti-inflammatory effects and it remains unclear if they modify the risk of AMD.

Objective: To investigate the association between AChEI medications and the incidence of AMD.

Design, setting, and participants: This propensity score-matched retrospective cohort study took place at health care facilities within the US Department of Veterans Affairs (VA) health care system from January 2000 through September 2023. Participants included patients diagnosed with AD between ages 55 and 80 years with no preexisting diagnosis of AMD in the VA database.

Exposure: AChEIs prescription dispensed as pharmacologic treatments for AD.

Main outcomes and measure: The first diagnosis of AMD.

Results: A total of 21 823 veterans with AD (mean [SD] age, 72.3 [6.1] years; 21 313 male participants [97.7%] and 510 female participants [2.3%]) were included. Propensity score-matched Cox model reveals each additional year of AChEI treatment was associated with a 6% lower hazard of AMD (hazard ratio, 0.94; 95% CI, (0.89-0.99).

Conclusions and relevance: This observational study reports a small reduction in the risk of AMD among veterans with AD receiving AChEIs. Randomized clinical trials would be needed to determine if there is a cause-and-effect relationship and further research is required to validate these findings across diverse populations.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Sutton reported support from the National Health Institutes and the South Carolina Center for Rural and Primary Healthcare and grants from Boehringer Ingelheim, Coherus BioSciences, EMD Serono, and Alexion Pharmaceuticals outside of the submitted work. Dr Magagnoli reported grants from the National Health Institutes outside of the submitted work. Dr Cummings reported grants from the National Institutes of Health and the South Carolina Center for Rural and Primary Healthcare for projects outside of the submitted work. Dr Ambati reported grants from University of Virginia during the conduct of the study and grants from the National Institutes of Health, being a cofounder of DiceRx, iVeena Holdings, iVeena Delivery Systems, and Inflammasome Therapeutics, and personal fees from Abbvie/Allergan, Boehringer-Ingelheim, Janssen, Olix Pharmaceuticals, Retinal Solutions, and Saksin LifeSciences outside the submitted work; in addition, Dr Ambati also had patents for Alzheimer disease macular degeneration licensed to Inflammasome Therapeutics, a patent pending for University of Virginia, and a patent for University of Kentucky issued. No other disclosures were reported.

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References

    1. Tahami Monfared AA, Byrnes MJ, White LA, Zhang Q. Alzheimer’s disease: epidemiology and clinical progression. Neurol Ther. 2022;11(2):553-569. doi:10.1007/s40120-022-00338-8 - DOI - PMC - PubMed
    1. Li X, Feng X, Sun X, Hou N, Han F, Liu Y. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990-2019. Front Aging Neurosci. 2022;14:937486. doi:10.3389/fnagi.2022.937486 - DOI - PMC - PubMed
    1. Atri A. Current and future treatments in Alzheimer’s disease. Semin Neurol. 2019;39(2):227-240. doi:10.1055/s-0039-1678581 - DOI - PubMed
    1. Tan ECK, Johnell K, Garcia-Ptacek S, et al. . Acetylcholinesterase inhibitors and risk of stroke and death in people with dementia. Alzheimers Dement. 2018;14(7):944-951. doi:10.1016/j.jalz.2018.02.011 - DOI - PubMed
    1. Nordström P, Religa D, Wimo A, Winblad B, Eriksdotter M. The use of cholinesterase inhibitors and the risk of myocardial infarction and death: a nationwide cohort study in subjects with Alzheimer’s disease. Eur Heart J. 2013;34(33):2585-2591. doi:10.1093/eurheartj/eht182 - DOI - PubMed

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