title: The Association of Statin Use with Age-Related Macular Degeneration Progression: The Age-Related Eye Disease Study 2 Report Number 9.
abstract: OBJECTIVE
  To evaluate the association of statin use with progression of age-related macular degeneration (AMD).
  
  
  METHODS
  Preplanned, prospective cohort study within a controlled clinical trial of oral supplementation for age-related eye diseases.
  
  
  METHODS
  Age-Related Eye Disease Study 2 (AREDS2) participants, aged 50 to 85 years.
  
  
  METHODS
  Factors, including age, gender, smoking status, aspirin use, and history of diabetes, hypertension, heart disease, angina, and stroke-all known to be associated with statin use-were included in a logistic regression model to estimate propensity scores for each participant. Age-adjusted proportional hazards regression models, with and without propensity score matching, were performed to evaluate the association of statin use with progression to late AMD. Analyses adjusting for the competing risk of death were also performed.
  
  
  METHODS
  Baseline and annual stereoscopic fundus photographs were assessed centrally by masked graders for the development of late AMD, either neovascular AMD or geographic atrophy (GA).
  
  
  RESULTS
  Of the 3791 participants (2462 with bilateral large drusen and 1329 with unilateral late AMD at baseline), 1659 (43.8%) were statin users. The overall analysis, with no matching of propensity scores and no adjustment for death as a competing risk, showed that statin use was not associated with progression to late AMD (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.83-1.41; P = 0.56). When matched for propensity scores and adjusted for death as a competing risk, the result was not statistically significant (HR, 0.81; 95% CI, 0.55-1.20; P = 0.29). Furthermore, subgroup analyses of persons with or without late AMD at baseline and the various components of late AMD (neovascular AMD, central GA, or any GA) also showed no statistically significant association of statin use with progression to AMD.
  
  
  CONCLUSIONS
  Statin use was not statistically significantly associated with progression to late AMD in the AREDS2 participants, and these findings are consistent with findings in the majority of previous studies. Statins have been demonstrated to reduce the risk of cardiovascular disease, but our data do not provide evidence of a beneficial effect on slowing AMD progression.
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute/National Institutes of Health, Bethesda, Maryland.
authors.forename: Shaza N
authors.initials: SN
authors.lastname: Al-Holou
authors.affiliation: Laboratory of Immunology, National Eye Institute/National Institutes of Health, Bethesda, Maryland.
authors.forename: William R
authors.initials: WR
authors.lastname: Tucker
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute/National Institutes of Health, Bethesda, Maryland.
authors.forename: Elvira
authors.initials: E
authors.lastname: Agrón
authors.affiliation: The EMMES Corporation, Rockville, Maryland.
authors.forename: Traci E
authors.initials: TE
authors.lastname: Clemons
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute/National Institutes of Health, Bethesda, Maryland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Cukras
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute/National Institutes of Health, Bethesda, Maryland.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Ferris
authors.affiliation: Clinical Trials Branch, Division of Epidemiology and Clinical Applications, National Eye Institute/National Institutes of Health, Bethesda, Maryland. Electronic address: echew@nei.nih.gov.
authors.forename: Emily Y
authors.initials: EY
authors.lastname: Chew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000188:drug therapy; D019587:Dietary Supplements; D018450:Disease Progression; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D057092:Geographic Atrophy / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D014975:Lutein / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D065146:Zeaxanthins / Q000008:administration & dosage
chemical_list: D015525:Fatty Acids, Omega-3; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D065146:Zeaxanthins; D014975:Lutein