Skip to main content
SpringerLink
Log in

NSAID Use and the Risk of Parkinson’s Disease

Systematic Review and Meta-Analysis of Observational Studies

  • Original Research Article
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Background

Several studies have suggested that NSAID use may modify the risk of developing Parkinson’s disease (PD).

Objective

Our aim was to conduct a meta-analysis of observational studies evaluating NSAID use and the risk of PD.

Methods

We systematically searched MEDLINE (1966–November 2008), EMBASE (1980–November 2008) and other databases. Data from 11 studies were included in the meta-analysis. We used the random effects model to calculate risk ratios (relative risks) and their corresponding 95% confidence intervals (CIs).

Results

The pooled risk ratio of PD with NSAID use was 0.95 (95% CI 0.80, 1.12). The pooled risk ratio of PD with high-dose or long-duration NSAID use was 0.91 (95% CI 0.78, 1.05). The pooled risk ratio of PD for aspirin (acetylsalicylic acid) users was 1.08 (95% CI 0.93, 1.26). The pooled risk ratio of PD among ibuprofen users was 0.76 (95% CI 0.65, 0.89). The pooled risk ratio of PD in men using NSAIDs was 0.79 (95% CI 0.69, 0.92), and in women using NSAIDs, it was 0.72 (95% CI 0.45, 1.15).

Conclusions

NSAIDs as a class do not seem to modify the risk of PD. However, ibuprofen may have a slight protective effect in lowering the risk of PD. Although the risk ratios of PD in male and female NSAID users were similar, the 95% CI for men was suggestive of a slight risk reduction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Fig 1
Fig 2
Fig 3
Fig. 4
Table II
Fig. 5

Similar content being viewed by others

References

  1. Samii A, Nutt JG, Ransom BR. Parkinson’s disease. Lancet 2004; 363: 1783–93

    Article  PubMed  CAS  Google Scholar 

  2. Litvan I, Chesselet MF, Gasser T, et al. The etiopathogenesis of Parkinson disease and suggestions for future research: part II. J Neuropathol Exp Neurol 2007; 66(5): 329–36

    Article  PubMed  CAS  Google Scholar 

  3. Schapira AH. Mitochondria in the aetiology and pathogenesis of Parkinson’s disease. Lancet Neurol 2008; 7(1): 97–109

    Article  PubMed  CAS  Google Scholar 

  4. Beal MF. Mitochondria, oxidative damage, and inflammation in Parkinson’s disease. Ann N Y Acad Sci 2003; 991: 120–31

    Article  PubMed  CAS  Google Scholar 

  5. Monahan AJ, Warren M, Carvey PM. Neuroinflammation and peripheral immune infiltration in Parkinson’s disease: an autoimmune hypothesis. Cell Transplant 2008; 17(4): 363–72

    PubMed  Google Scholar 

  6. McGeer PL, McGeer EG. Glial reactions in Parkinson’s disease. Mov Disord 2008; 23(4): 474–83

    Article  PubMed  Google Scholar 

  7. Asanuma M, Miyazaki I. Common anti-inflammatory drugs are potentially therapeutic for Parkinson’s disease?. Exp Neurol 2007; 206(2): 172–8

    Article  PubMed  CAS  Google Scholar 

  8. Bower JH, Maraganore DM, Peterson BJ, et al. Immunologic diseases, anti-inflammatory drugs, and Parkinson disease: a case-control study. Neurology 2006; 67(3): 494–6

    Article  PubMed  CAS  Google Scholar 

  9. Etminan M, Suissa S. NSAID use and the risk of Parkinson’s disease. Curr Drug Saf 2006; 1: 223–5

    Article  PubMed  CAS  Google Scholar 

  10. Hernán MA, Logroscino G, García Rodríguez LA. Non-steroidal anti-inflammatory drugs and the incidence of Parkinson disease. Neurology 2006; 66(7): 1097–9

    Article  PubMed  Google Scholar 

  11. Ton TG, Heckbert SR, Longstreth Jr WT, et al. Nonsteroidal anti-inflammatory drugs and risk of Parkinson’s disease. Mov Disord 2006; 21(7): 964–9

    Article  PubMed  Google Scholar 

  12. Hancock DB, Martin ER, Stajich JM, et al. Smoking, caffeine, and nonsteroidal anti-inflammatory drugs in families with Parkinson disease. Arch Neurol 2007; 64(4): 576–80

    Article  PubMed  Google Scholar 

  13. Powers KM, Kay DM, Factor SA, et al. Combined effects of smoking, coffee, and NSAIDs on Parkinson’s disease risk. Mov Disord 2008; 23(1): 88–95

    Article  PubMed  Google Scholar 

  14. Wahner AD, Bronstein JM, Bordelon YM, et al. Nonsteroidal anti-inflammatory drugs may protect against Parkinson disease. Neurology 2007; 69(19): 1836–42

    Article  PubMed  CAS  Google Scholar 

  15. Chen H, Zhang SM, Hernán MA, et al. Nonsteroidal anti-inflammatory drugs and the risk of Parkinson disease. Arch Neurol 2003; 60(8): 1059–64

    Article  PubMed  Google Scholar 

  16. Chen H, Jacobs E, Schwarzschild MA, et al. Nonsteroidal antiinflammatory drug use and the risk for Parkinson’s disease. Ann Neurol 2005; 58(6): 963–7

    Article  PubMed  CAS  Google Scholar 

  17. Bornebroek M, de Lau LM, Haag MD, et al. Nonsteroidal anti-inflammatory drugs and the risk of Parkinson disease. Neuroepidemiology 2007; 28(4): 193–6

    Article  PubMed  Google Scholar 

  18. Etminan M, Carleton BC, Samii A. Non-steroidal anti-inflammatory drug use and the risk of Parkinson disease: a retrospective cohort study. J Clin Neurosci 2008; 15(5): 576–7

    Article  PubMed  CAS  Google Scholar 

  19. Parepally JM, Mandula H, Smith QR. Brain uptake of nonsteroidal anti-inflammatory drugs: ibuprofen, flurbiprofen, and indomethacin. Pharm Res 2006; 23(5): 873–81

    Article  PubMed  CAS  Google Scholar 

  20. Casper D, Yaparpalvi U, Rempel N, et al. Ibuprofen protects dopaminergic neurons against glutamate toxicity in vitro. Neurosci Lett 2000; 289(3): 201–4

    Article  PubMed  CAS  Google Scholar 

  21. Kurkowska-Jastrzebska I, Członkowski A, Członkowska A. Ibuprofen and the mouse model of Parkinson’s disease. Ann Neurol 2006; 59(6): 988–9

    Article  PubMed  Google Scholar 

  22. Elsisi NS, Darling-Reed S, Lee EY, et al. Ibuprofen and apigenin induce apoptosis and cell cycle arrest in activated microglia. Neurosci Lett 2005; 375(2): 91–6

    Article  PubMed  CAS  Google Scholar 

  23. Braak H, Del Tredici K. Nervous system pathology in sporadic Parkinson disease. Neurology 2008; 70(20): 1916–25

    Article  PubMed  Google Scholar 

  24. Schapira AH. Progress in neuroprotection in Parkinson’s disease. Eur J Neurol 2008; 15Suppl. 1: 5–13

    Article  PubMed  Google Scholar 

  25. Ravina B, Eidelberg D, Ahlskog JE, et al. The role of radiotracer imaging in Parkinson disease. Neurology 2005; 64(2): 208–15

    Article  PubMed  CAS  Google Scholar 

  26. McGeer EG, McGeer PL. The role of anti-inflammatory agents in Parkinson’s disease. CNS Drugs 2007; 21(10): 789–97

    Article  PubMed  CAS  Google Scholar 

  27. Tansey MG, Frank-Cannon TC, McCoy MK, et al. Neuro-inflammation in Parkinson’s disease: is there sufficient evidence for mechanism-based interventional therapy? Front Biosci 2008; 13: 709–17

    Article  PubMed  CAS  Google Scholar 

  28. Klegeris A, McGeer EG, McGeer PL. Therapeutic approaches to inflammation in neurodegenerative disease. Curr Opin Neurol 2007; 20(3): 351–7

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this paper.

Author information

Authors and Affiliations

  1. Department of Neurology, University of Washington, and the Seattle VA Parkinson Disease Research Education and Clinical Center, Seattle, Washington, USA

    Ali Samii (Associate Professor of Neurology)

  2. Centre for Clinical Epidemiology and Evaluation, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Mahyar Etminan

  3. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada

    Matthew O. Wiens

  4. Chilliwack General Hospital, Chilliwack, British Columbia, Canada

    Matthew O. Wiens

  5. School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada

    Siavash Jafari

Authors
  1. Ali Samii
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mahyar Etminan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Matthew O. Wiens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Siavash Jafari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ali Samii.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Samii, A., Etminan, M., Wiens, M.O. et al. NSAID Use and the Risk of Parkinson’s Disease. Drugs Aging 26, 769–779 (2009). https://doi.org/10.2165/11316780-000000000-00000

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/11316780-000000000-00000

Keywords

Search

Navigation