A recent study published in JAMA Ophthalmology investigated the association between age-related macular degeneration (AMD) and a specific Alzheimer’s disease (AD) drug.
Give me some background first.
Acetylcholinesterase inhibitors (AChEIs) are commonly prescribed for AD, and have shown secondary benefits, such as lowered mortality and slowed progression of certain diseases—including in the macula.
It was hypothesized that the anti-inflammatory effects of AChEIs might influence the risk levels of
AMD, and thus researchers conducted an observational study.
Now, talk about the study.
In this retrospective cohort study, 21,823 participants were selected from the U.S. Department of Veterans Affairs (VA). The patients had the following characteristics:
- Diagnosed with AD prior to 2020
- Between 55 to 80 years old at the index date
- No pre-existing AMD diagnoses
Go on…
The study included a time frame for data from the VA health facilities of 2000 to 2023, comparing participants who had received pharmacological treatments for AD and those unexposed to treatment.
Findings?
A propensity score-matched Cox model was used in this study. The results displayed a 6% lower hazard rate for AMD in participants who used AChEIs as compared to untreated patients.
Those treated with AChEIs also consistently yielded lower AMD incidence across the follow-up period.
Expert opinion?
Per the study authors, “While improving cognitive outcomes is the primary goal of therapy with AChEIs, these secondary benefits can play a significant role in the decision to treat or continue treatment.”
Limitations?
Potential selection bias was introduced due to both the study and the groups that received certain treatments not being randomized.
In addition, the findings may not be generalizable to a greater population due to the use of data specifically from the VA department.
Take home.
While further research is necessary to confirm these findings in both causal manner and in diverse populations, this could display meaningful secondary benefits of the drug.
The authors concluded that, “The reported associations are important because they potentially suggest broad therapeutic potential that should be evaluated with further randomized clinical trials to confirm the findings.”