Low-Dose Aspirin and Progression of Age-Related Hearing Loss: A Secondary Analysis of the ASPREE Randomized Clinical Trial.

Autor:	Clark DPQ; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Alfred Hospital, Victoria, Australia., Zhou Z; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia., Hussain SM; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.; The School of Population and Global Health, The University of Melbourne, Victoria, Australia., Tran C; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia., Britt C; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia., Storey E; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Alfred Hospital, Victoria, Australia., Lowthian JA; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.; Bolton Clarke Research Institute, Forrest Hill, Victoria, Australia., Shah RC; Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, Illinois.; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois., Dillon H; The HEARing Cooperative Research Centre, Melbourne, Victoria, Australia.; Hearing Research Centre, Macquarie University, New South Wales, Australia.; Manchester Centre for Audiology and Deafness, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom., Wolfe R; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia., Woods RL; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia., Rance G; The HEARing Cooperative Research Centre, Melbourne, Victoria, Australia., McNeil JJ; The School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2024 Jul 01; Vol. 7 (7), pp. e2424373. Date of Electronic Publication: 2024 Jul 01.
DOI:	10.1001/jamanetworkopen.2024.24373
Abstrakt:	Importance: Age-related hearing loss is common in an aging population, affecting communication and contributing to a worsened quality of life. It occurs as a result of cochlear degeneration and may be further exacerbated by inflammation and microvascular changes, as observed in animal models. Objective: To compare the effect of daily low-dose aspirin vs placebo on the progression of age-related hearing loss in healthy older adults. Design, Setting, and Participants: A prespecified secondary analysis was conducted of the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial. Participants were 279 healthy community-dwelling individuals living in Australia who were aged 70 years or older and free of overt cardiovascular diseases, dementia, and life-limiting illnesses. Participants were recruited between January 1, 2010, and December 31, 2014, and followed up over 3 years. Statistical analysis was completed from June to December 2023. Intervention: A 100-mg daily dose of enteric-coated aspirin or matching placebo. Main Outcomes and Measures: Hearing measures were air conduction audiometry and binaural speech perception in noise. Assessments were conducted at baseline, 18 months, and 3 years. The change from baseline hearing measures were analyzed using an intention to treat approach. Aspirin and placebo were compared using mixed linear regression models adjusting for age, sex, diabetes, and smoking. Results: Of 279 participants, 154 (55%) were male, and the median age at baseline was 73.1 years (IQR, 71.5-76.2 years). A total of 98 of 138 participants (71%) in the aspirin group and 94 of 141 participants (67%) in the placebo group reported experiencing hearing loss at baseline. Compared with placebo, aspirin did not affect the changes in mean (SD) 4-frequency average hearing threshold from baseline to year 3 (aspirin: baseline, 27.8 [13.3] dB; year 3, 30.7 [13.7] dB; difference, 3.3 [3.9] dB; placebo: baseline, 27.5 [12.6] dB; year 3, 30.9 [13.8] dB; difference, 3.0 [4.8] dB; P = .55) nor any other tested frequencies. An increase in air conduction threshold indicates a deterioration in hearing. Similarly, for the mean (SD) speech reception threshold, there was no significant difference observed between the aspirin and placebo group at the year 3 follow-up assessment (aspirin: baseline, -9.9 [3.8] dB; year 3, -9.1 [3.8] dB; difference, 0.9 [2.9] dB; placebo: baseline, -10.5 [7.1] dB; year 3, -9.6 [4.1] dB; difference, 0.9 [5.9] dB; P = .86). The findings were consistent across sex, age groups, diabetic and smoking status. Conclusions and Relevance: In this secondary analysis of the ASPREE randomized clinical trial, low-dose aspirin did not affect the progression of age-related hearing loss. More investigation is warranted on whether a longer follow-up or the use of a more powerful anti-inflammatory agent might prove beneficial. Trial Registration: anzctr.org.au Identifier: ACTRN12614000496617.
Databáze:	MEDLINE
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