ALS Patients May Benefit from Aspirin Therapy

A recent study assessed the association between individual prescription compounds and amyotrophic lateral sclerosis (ALS) risk in a population-based study in Taiwan. The study entitled “Aspirin use associated with amyotrophic lateral sclerosis: a total population-based case-control study” was published in the Journal of Epidemiology by Dr. Ching-Piao Tsai, first author, and Dr. Charles Tzu-Chi Lee, senior author, from the Department of Public Health, Kaohsiung Medical University, Taiwan, and colleagues.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Death due to respiratory failure without mechanical ventilation support follows within 2 to 5 years of the onset of symptoms. There has been an increase in the prevalence and incidence of ALS in Hong Kong, Japan, Sweden, and probably globally. The only medication used for ALS treatment is riluzole and improves quality of life and survival of patients but does not cure the disease. The use of anti-inflammatory drugs (to prevent the disease or slow its progression) to treat ALS gave conflicting results in studies, despite evidence indicating that local cytotoxic inflammation occurs in ALS. Classes of drugs similar to NSAIDs have heterogeneous effects and an individual compound might contribute to ALS.

The association of aspirin 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. The major strength of this study was the large human sample.

The authors then considered the multiple-comparison problem and adjusted the results using the statistical method used in multiple hypothesis testing to correct for multiple comparisons, i.e. the false discovery rate (FDR) method, only aspirin, diphenhydramine (one of the antihistamines), and mefenamic acid (one of the NSAIDs) were significantly associated with ALS. The researchers found that the aspirin usage exhibited an independent inverse association with ALS risk within men and women older than 55 years, but there was no significant association among patients aged 15 to 54 years. This observation may be explained by a longer duration use of aspirin in older people than in the younger age group. The inverse association between aspirin and ALS was present predominately in patients older than 55 years.

In conclusion, these findings suggested that aspirin usage may reduce the risk of ALS, and is likely to be more beneficial for older people.