Aspirin use associated with amyotrophic lateral sclerosis: A total population-based case-control study

Ching Piao Tsai, Feng Cheng Lin, Johnny Kuang Wu Lee, Charles Tzu Chi Lee*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background: The association of aspirin use 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. Methods: A total of 729 patients with newly diagnosed ALS who had a severely disabling disease certificate between January 1, 2002, and December 1, 2008, comprised the case group. These cases were compared with 7290 sex-, age-, residence-, and insurance premium-matched controls. Drug use by each Anatomical Therapeutic Chemical code was analyzed using conditional logistic regression models. False discovery rate (FDR)-adjusted P values were reported in order to avoid inflating false positives. Results: Of the 1336 compounds, only the 266 with use cases exceeding 30 in our database were included in the screening analysis. Without controlling for steroid use, the analysis failed to reveal any compound that was inversely associated with ALS risk according to FDR criteria. After controlling for steroid use, we found use of the following compounds to be associated with ALS risk: aspirin, diphenhydramine (one of the antihistamines), and mefenamic acid (one of the NSAIDs). A multivariate analysis revealed that aspirin was independently inversely associated with ALS risk after controlling for diphenhydramine, mefenamic acid, and steroid use. The inverse association between aspirin and ALS was present predominately in patients older than 55 years. Conclusions: The results of this study suggested that aspirin use might reduce the risk of ALS, and the benefit might be more prominent for older people.

Original languageEnglish
Pages (from-to)172-177
Number of pages6
JournalJournal of Epidemiology
Issue number2
Publication statusPublished - 2015
Externally publishedYes


  • Amyotrophic lateral sclerosis
  • Aspirin
  • Case-control study

ASJC Scopus subject areas

  • Epidemiology


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