Influence of Long-term Non-Aspirin NSAID use on Risk of Frailty in Men ≥60 years: The Physicians’ Health Study

2022 ◽  
Author(s):  
Ariela R Orkaby ◽  
Rachel Ward ◽  
Jiaying Chen ◽  
Akshay Shanbhag ◽  
Howard D Sesso ◽  
...  
Keyword(s):  
Propensity Score ◽  
Frailty Index ◽  
Health Study ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Propensity Score Adjustment

Abstract Background Inflammation is a central pathway leading to frailty but whether commonly used non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) can prevent frailty is unknown. Methods Prospective cohort study of male physicians ≥60 who participated in the Physicians’ Health Study. Annual questionnaires collected data on NSAID use, lifestyle and morbidity. Average annual NSAID use was categorized as 0 days/year, 1-12 days/year, 13-60 days/year, and >60 days/year. Frailty was assessed using a validated 33-item frailty index. Propensity score inverse probability of treatment weighting was used to address confounding by indication and logistic regression models estimated odds ratios (ORs) of prevalent frailty according to non-aspirin NSAID use. Results 12,101 male physicians were included (mean age 70±7 years, mean follow-up 11 years). Reported NSAID use was 0 days/year for 2,234, 1-12 days/year for 5,812, 13-60 days/year for 2,833, and >60 days/year for 1,222 participants. 2,413 participants (20%) were frail. Higher self-reported NSAID use was associated with greater alcohol use, smoking, arthritis, hypertension, and heart disease, while less NSAID use was associated with coumadin use and prior bleeding. After propensity score adjustment, all characteristics were balanced. ORs (95% CIs) of prevalent frailty were 0.90 (0.80-1.02), 1.02 (0.89-1.17), and 1.26 (1.07-1.49) for average NSAID use of 1-12 days/year, 13-60 days/year, and >60 days/year, compared to 0 days/year (p-trend<0.001). Conclusions Long term use of NSAIDs at high frequency is associated with increased risk of frailty among older men. Additional study is needed to understand the role of anti-inflammatory medication in older adults and its implication for overall health.

scholarly journals Association Between Long-Term Aspirin Use and Frailty in Men: The Physicians’ Health Study

2020 ◽  
Author(s):  
Ariela R Orkaby ◽  
Laiji Yang ◽  
Alyssa B Dufour ◽  
Thomas G Travison ◽  
Howard D Sesso ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Health Study ◽  
Statistical Control ◽  
Logistic Regression Models ◽  
Regular Aspirin ◽  
Anti Inflammatory ◽  
Definition Of ◽  
Reported Data

Abstract Background Chronic inflammation may lead to frailty, however the potential for anti-inflammatory medications such as aspirin to prevent frailty is unknown. We sought to examine the association between long-term aspirin use and prevalent frailty. Methods We included 12 101 men ≥60 years who participated in the Physicians’ Health Study I, a completed aspirin randomized controlled trial (1982–1989). Annual questionnaires collected self-reported data on daily aspirin use, lifestyle, and clinical variables. Average aspirin use was summed into 2 categories: ≤60 days/year and >60 days/year. Frailty was assessed using a 33-item index 11 years after trial completion. A score of ≥0.21 was considered frail. Propensity score inverse probability of treatment weighting was used for statistical control of confounding. Logistic regression models estimated odds of frailty as a function of categories of average aspirin use. Results Mean age was 70.5 years (range 60–101). Following an average of 11 ± 0.6 years of follow-up, aspirin use was reported as ≤60 days/year for 15%; 2413 participants (20%) were frail. Frequency of aspirin use was associated with smoking, alcohol consumption, hypertension, and cardiovascular disease, but negatively associated with bleeding and Coumadin use. The odds ratio (95% confidence intervals) for frailty was 0.85 (0.76–0.96) for average aspirin use >60 days/year versus aspirin use ≤60 days/year. Results were similar using an alternate definition of frailty. Conclusions Long-term regular aspirin use is inversely associated with frailty among older men, even after consideration of multimorbidity and health behaviors. Work is needed to understand the role of medications with anti-inflammatory properties on aging.

scholarly journals Role of diuretics on long-term mortality may differ in volume status in patients with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Kawai ◽  
D Nakatani ◽  
T Yamada ◽  
T Watanabe ◽  
T Morita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Propensity Score ◽  
Plasma Volume ◽  
Cox Regression ◽  
Volume Status ◽  
Increased Risk ◽  
Long Term Mortality

Abstract Background Diuretics has been reported to have a potential for an activation of the renin-angiotensin-aldosterone system and the sympathetic nervous system, leading to a possibility of poor clinical outcome in patients with cardiovascular disease. However, few data are available on clinical impact of diuretics on long-term outcome in patients with acute myocardial infarction (AMI) based on plasma volume status. Methods To address the issue, a total of 3,416 survived patients with AMI who were registered to a large database of the Osaka Acute Coronary Insufficiency Study (OACIS) were studied. Plasma volume status was assessed with the estimated plasma volume status (ePVS) that was calculated at discharge as follows: actual PV = (1 − hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females), and ePVS = [(actual PV − ideal PV)/ideal PV] × 100 (%). Multivariable Cox regression analysis and propensity score matching were performed to account for imbalances in covariates. The endpoint was all-cause of death (ACD) within 5 years. Results During a median follow-up period of 855±656 days, 193 patients had ACD. In whole population, there was no significant difference in long-term mortality risk between patients with and without diuretics in both multivariate cox regression model and propensity score matching population. When patients were divided into 2 groups according to ePVS with a median value of 4.2%, 46 and 147 patients had ACD in groups with low ePVS and high ePVS, respectively. Multivariate Cox analysis showed that use of diuretics was independently associated with an increased risk of ACD in low ePVS group, (HR: 2.63, 95% confidence interval [CI]: 1.22–5.63, p=0.01), but not in high ePVS group (HR: 0.70, 95% CI: 0.44–1.10, p=0.12). These observations were consistent in the propensity-score matched cohorts; the 5-year mortality rate was significantly higher in patients with diuretics than those without among low ePVS group (4.7% vs 1.7%, p=0.041), but not among high ePVS group (8.0% vs 10.3%, p=0.247). Conclusion Prescription of diuretics at discharge was associated with increased risk of 5-year mortality in patients with AMI without PV expansion, but not with PV expansion. The role of diuretics on long-term mortality may differ in plasma volume status. Therefore, prescription of diuretics after AMI may be considered based on plasma volume status. Funding Acknowledgement Type of funding source: None

scholarly journals A Translational Perspective of Maternal Immune Activation by SARS-CoV-2 on the Potential Prenatal Origin of Neurodevelopmental Disorders: The Role of the Cholinergic Anti-inflammatory Pathway

2021 ◽  
Vol 12 ◽  
Author(s):  
José Javier Reyes-Lagos ◽  
Eric Alonso Abarca-Castro ◽  
Juan Carlos Echeverría ◽  
Hugo Mendieta-Zerón ◽  
Alejandra Vargas-Caraveo ◽  
...  
Keyword(s):  
Immune Activation ◽  
Neurodevelopmental Disorders ◽  
Inflammatory Pathway ◽  
Maternal Immune Activation ◽  
Increased Risk ◽  
Anti Inflammatory ◽  
Psychophysiological Data

The emergent Coronavirus Disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) could produce a maternal immune activation (MIA) via the inflammatory response during gestation that may impair fetal neurodevelopment and lead to postnatal and adulthood mental illness and behavioral dysfunctions. However, so far, limited evidence exists regarding long-term physiological, immunological, and neurodevelopmental modifications produced by the SARS-CoV-2 in the human maternal-fetal binomial and, particularly, in the offspring. Relevant findings derived from epidemiological and preclinical models show that a MIA is indeed linked to an increased risk of neurodevelopmental disorders in the offspring. We hypothesize that a gestational infection triggered by SARS-CoV-2 increases the risks leading to neurodevelopmental disorders of the newborn, which can affect childhood and the long-term quality of life. In particular, disruption of either the maternal or the fetal cholinergic anti-inflammatory pathway (CAP) could cause or exacerbate the severity of COVID-19 in the maternal-fetal binomial. From a translational perspective, in this paper, we discuss the possible manifestation of a MIA by SARS-CoV-2 and the subsequent neurodevelopmental disorders considering the role of the fetal-maternal cytokine cross-talk and the CAP. Specifically, we highlight the urgent need of preclinical studies as well as multicenter and international databanks of maternal-fetal psychophysiological data obtained pre-, during, and post-infection by SARS-CoV-2 from pregnant women and their offspring.

Long-Term Aspirin Use and Self-Reported Walking Speed in Older Men: The Physicians’ Health Study

2021 ◽  
pp. 1-6
Author(s):  
A.R. Orkaby ◽  
A.B. Dufour ◽  
L. Yang ◽  
H.D. Sesso ◽  
J.M. Gaziano ◽  
...  
Keyword(s):  
Walking Speed ◽  
Multinomial Logistic Regression ◽  
Controlled Trial ◽  
Older Men ◽  
Mobility Limitation ◽  
Health Study ◽  
Logistic Regression Models ◽  
Post Trial ◽  
Propensity Score Adjustment

Background: Mobility limitation is a component of frailty that shares a bidirectional relationship with cardiovascular disease (CVD). Data are limited on the role of established CVD prevention therapies, such as aspirin, for prevention of frailty and mobility limitation. Objectives: Examine the association between long-term aspirin use and walking speed. Design, Setting, Participants: Prospective cohort of 14,315 men who participated in the Physicians’ Health Study I, a completed randomized controlled trial of aspirin (1982-1988), with extended post-trial follow-up. Measurements: Annual questionnaires collected data on aspirin use, lifestyle and other factors. Average annual aspirin use was categorized for each participant: ≤60 days/year and >60 days/year. Mobility was defined according to self-reported walking pace, categorized as: don’t walk regularly (reference), easy/casual <2mph, normal ≥2-2.9mph, or brisk/very brisk ≥3mph. Propensity scoring balanced covariates between aspirin categories. Multinomial logistic regression models estimated odds of being in each self-reported walking category. Results: Mean age was 70±8 years; mean aspirin use 11 years. There were 2,056 (14.3%) participants who reported aspirin use ≤60 days/year. Aspirin use >60 days/year was associated with drinking alcohol, smoking, hypertension, heart disease and stroke, while ≤60 days/year was associated with anticoagulation use and bleeding history. In all, 13% reported not walking regularly, 12% walked <2 mph, 44% walked ≥2-2.9 mph, and 31% walked ≥3 mph. After propensity score adjustment, regular aspirin use was associated with a faster walking speed. Odds ratios (95% confidence intervals) were 1.16 (0.97 to 1.39), 1.24 (1.08 to 1.43), and 1.40 (1.21 to 1.63) for <2 mph, ≥2-2.9 mph and ≥3 mph, respectively, compared to not walking regularly (p-trend<0.001). Conclusions: In this cohort of older men, long-term aspirin use is associated with a greater probability of faster walking speed later in life.

scholarly journals The use of hyaluronic acid preparations for the treatment of osteoarthritis of the major joints

2021 ◽  
Vol 4 (2) ◽  
pp. 11-16
Author(s):  
O Kalashnikov ◽  
O Sulyma ◽  
T Osadchuk ◽  
V Zayets ◽  
T Nizalov ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Side Effects ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
High Level ◽  
Time Of Administration ◽  
Inflammatory Effect ◽  
The Ideal

The authors of the article analyzed the experience of domestic and foreign experts in the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major joints. Background  and  Objective. To analyze the literature sources in order to determine the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major ligaments. Materials and methods. Articles in specialized scientific journals and collections, Internet resource.Results. The analysis of literature sources determined the important role of HA preparations in the supplying and functioning of the articular cartilage. Researchers are inclined to believe that the ideal HA preparation should be as close as possible to the physiological HA of the synovial fluid of the joint. The developed domestic drug Artro-Patch fully corresponds to these parameters. Conclusions. The use of modern injectable HA preparations is advisable at stages 1–3 of OA. Anti-inflammatory effect of HA preparations makes it possible to reduce the dose and time of administration of non-steroidal anti-inflammatory drugs and, as a consequence, reduce the risk of developing many adverse side effects of NSAIDs. The high level of safety of HA preparations, the absence of serious side effects during their long-term use determine their widespread use in the clinical practice of modern orthopedists.

scholarly journals Practical use of non-steroidal anti-inflammatory drugs in relieving recurrent headaches

2021 ◽  
Vol 23 (2) ◽  
pp. 148-153
Author(s):  
Gyuzyal R. Тabeeva ◽  
◽  
Ekaterina A. Kiryanova ◽  
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Headache ◽  
The World ◽  
Headache Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Rule Out

The main burden of headache in the world falls on primary cephalalgia (tension headache, migraine). However, there is often a need to rule out a secondary cause of the headache. This review presents the main options for the differential diagnosis of cephalgias, taking into account the patient’s age, headache characteristics, and anamnestic information. The role of non-steroidal anti-inflammatory drugs in headache treatment, the safety of its long-term use and prevention of medication overuse headache are discussed.

scholarly journals The effect of inflammatory response modulator agents on gingivitis and periodontitis

2016 ◽  
Vol 64 (3) ◽  
pp. 312-319
Author(s):  
Juliano CAVAGNI ◽  
Francisco Wilker Mustafa Gomes MUNIZ ◽  
Cassiano Kuchenbecker RÖSING
Keyword(s):  
Host Response ◽  
Animal Studies ◽  
Inflammatory Diseases ◽  
Periodontal Diseases ◽  
Therapeutic Procedures ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Microbial Challenge

ABSTRACT Periodontal diseases are infecto-inflammatory diseases. Literature, has tried to elucidate the infections component of gingivitis and periodontitis, for several years. In recent years, much has been discussed about the role of the host response modulators to periodontal therapeutic procedures. The aim of the present literature review was to evaluate the effect of host response modulating agents (anti-inflammatories) on the pathogenesis of gingivitis and periodontitis. A search in the main databases was performed and human and animal studies were selected. The majority of studies was performed in humans and non-steroidal anti-inflammatory drugs in different dosages were used. The results have shown a potential benefit of the non-steroidal anti-inflammatory drugs concerning the microbial challenge. However, this benefit seems not to occur in the long term, thus not supporting it as a periodontal therapeutic approach. Few studies evaluated the effect of steroidal anti-inflammatory drugs on the pathogenesis of periodontal diseases. Moreover, the results in humans and animals are controversial, pointing to a possible deleterious effect of steroidal anti-inflammatory drugs on periodontal structures.

scholarly journals Use of hyaluronic acid preparations for treatment of osteoarthritis of major ligaments

Pain medicine ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 37-42
Author(s):  
Oleksiy Kalashnikov ◽  
Oleksiy Sulyma ◽  
Taras Osadchuk ◽  
Volodymyr Zayets ◽  
Taras Nizalov ◽  
...  
Keyword(s):  
Side Effects ◽  
Internet Resource ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
High Level ◽  
Time Of Administration ◽  
Inflammatory Effect ◽  
The Ideal

The authors of the article analyzed the experience of domestic and foreign experts in the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major ligaments. Background and Objective. To analyze the literature sources in order to determine the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major ligaments. Materials and methods. Articles in specialized scientific journals and collections, Internet resource. Results. The analysis of literature sources determined the important role of HA preparations in the supplying and functioning of the articular cartilage. Researchers are inclined to believe that the ideal HA preparation should be as close as possible to the physiological HA of the synovial fluid of the joint. The developed domestic drug Arthro-Patch fully corresponds to these parameters. Conclusions. The use of modern injectable HA preparations is advisable at stages 1–3 of OA. Anti-inflammatory effect of HA preparations makes it possible to reduce the dose and time of administration of non-steroidal anti-inflammatory drugs and, as a consequence, reduce the risk of developing many adverse side effects of NSAIDs. The high level of safety of HA preparations, the absence of serious side effects during their long-term use determine their widespread use in the clinical practice of modern orthopedists.

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