Drugs & Aging

, Volume 26, Issue 9, pp 769–779 | Cite as

NSAID Use and the Risk of Parkinson’s Disease

Systematic Review and Meta-Analysis of Observational Studies
  • Ali Samii
  • Mahyar Etminan
  • Matthew O. Wiens
  • Siavash Jafari
Original Research Article

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.

References

  1. 1.
    Samii A, Nutt JG, Ransom BR. Parkinson’s disease. Lancet 2004; 363: 1783–93PubMedCrossRefGoogle Scholar
  2. 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): 329–36PubMedCrossRefGoogle Scholar
  3. 3.
    Schapira AH. Mitochondria in the aetiology and pathogenesis of Parkinson’s disease. Lancet Neurol 2008; 7(1): 97–109PubMedCrossRefGoogle Scholar
  4. 4.
    Beal MF. Mitochondria, oxidative damage, and inflammation in Parkinson’s disease. Ann N Y Acad Sci 2003; 991: 120–31PubMedCrossRefGoogle Scholar
  5. 5.
    Monahan AJ, Warren M, Carvey PM. Neuroinflammation and peripheral immune infiltration in Parkinson’s disease: an autoimmune hypothesis. Cell Transplant 2008; 17(4): 363–72PubMedGoogle Scholar
  6. 6.
    McGeer PL, McGeer EG. Glial reactions in Parkinson’s disease. Mov Disord 2008; 23(4): 474–83PubMedCrossRefGoogle Scholar
  7. 7.
    Asanuma M, Miyazaki I. Common anti-inflammatory drugs are potentially therapeutic for Parkinson’s disease?. Exp Neurol 2007; 206(2): 172–8PubMedCrossRefGoogle Scholar
  8. 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): 494–6PubMedCrossRefGoogle Scholar
  9. 9.
    Etminan M, Suissa S. NSAID use and the risk of Parkinson’s disease. Curr Drug Saf 2006; 1: 223–5PubMedCrossRefGoogle Scholar
  10. 10.
    Hernán MA, Logroscino G, García Rodríguez LA. Non-steroidal anti-inflammatory drugs and the incidence of Parkinson disease. Neurology 2006; 66(7): 1097–9PubMedCrossRefGoogle Scholar
  11. 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): 964–9PubMedCrossRefGoogle Scholar
  12. 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): 576–80PubMedCrossRefGoogle Scholar
  13. 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): 88–95PubMedCrossRefGoogle Scholar
  14. 14.
    Wahner AD, Bronstein JM, Bordelon YM, et al. Nonsteroidal anti-inflammatory drugs may protect against Parkinson disease. Neurology 2007; 69(19): 1836–42PubMedCrossRefGoogle Scholar
  15. 15.
    Chen H, Zhang SM, Hernán MA, et al. Nonsteroidal anti-inflammatory drugs and the risk of Parkinson disease. Arch Neurol 2003; 60(8): 1059–64PubMedCrossRefGoogle Scholar
  16. 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): 963–7PubMedCrossRefGoogle Scholar
  17. 17.
    Bornebroek M, de Lau LM, Haag MD, et al. Nonsteroidal anti-inflammatory drugs and the risk of Parkinson disease. Neuroepidemiology 2007; 28(4): 193–6PubMedCrossRefGoogle Scholar
  18. 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): 576–7PubMedCrossRefGoogle Scholar
  19. 19.
    Parepally JM, Mandula H, Smith QR. Brain uptake of nonsteroidal anti-inflammatory drugs: ibuprofen, flurbiprofen, and indomethacin. Pharm Res 2006; 23(5): 873–81PubMedCrossRefGoogle Scholar
  20. 20.
    Casper D, Yaparpalvi U, Rempel N, et al. Ibuprofen protects dopaminergic neurons against glutamate toxicity in vitro. Neurosci Lett 2000; 289(3): 201–4PubMedCrossRefGoogle Scholar
  21. 21.
    Kurkowska-Jastrzebska I, Członkowski A, Członkowska A. Ibuprofen and the mouse model of Parkinson’s disease. Ann Neurol 2006; 59(6): 988–9PubMedCrossRefGoogle Scholar
  22. 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): 91–6PubMedCrossRefGoogle Scholar
  23. 23.
    Braak H, Del Tredici K. Nervous system pathology in sporadic Parkinson disease. Neurology 2008; 70(20): 1916–25PubMedCrossRefGoogle Scholar
  24. 24.
    Schapira AH. Progress in neuroprotection in Parkinson’s disease. Eur J Neurol 2008; 15Suppl. 1: 5–13PubMedCrossRefGoogle Scholar
  25. 25.
    Ravina B, Eidelberg D, Ahlskog JE, et al. The role of radiotracer imaging in Parkinson disease. Neurology 2005; 64(2): 208–15PubMedCrossRefGoogle Scholar
  26. 26.
    McGeer EG, McGeer PL. The role of anti-inflammatory agents in Parkinson’s disease. CNS Drugs 2007; 21(10): 789–97PubMedCrossRefGoogle Scholar
  27. 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: 709–17PubMedCrossRefGoogle Scholar
  28. 28.
    Klegeris A, McGeer EG, McGeer PL. Therapeutic approaches to inflammation in neurodegenerative disease. Curr Opin Neurol 2007; 20(3): 351–7PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Ali Samii
    • 1
  • Mahyar Etminan
    • 2
  • Matthew O. Wiens
    • 3
    • 4
  • Siavash Jafari
    • 5
  1. 1.Department of NeurologyUniversity of Washington, and the Seattle VA Parkinson Disease Research Education and Clinical CenterSeattleUSA
  2. 2.Centre for Clinical Epidemiology and Evaluation, Department of Medicine, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  3. 3.Faculty of Pharmaceutical SciencesUniversity of British ColumbiaVancouverCanada
  4. 4.Chilliwack General HospitalChilliwackCanada
  5. 5.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada

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