NSAID impact on Parkinson’s disease risk in doubt
MedWire News: Regular use of non-steroidal anti-inflammatory agents (NSAIDs) does not reduce men's risk for developing Parkinson's disease (PD), shows an analysis of the Physicians' Health Study.
"NSAIDs have been proposed as potential preventive agents for PD, based on laboratory evidence as well as results from a few large observational studies," say Jane Driver (Brigham and Women's Hospital, Boston, Massachusetts, USA) and colleagues.
But the team's study - a case-control analysis nested within the Physicians' Health Study - found no clear evidence for an influence of NSAID use on PD risk.
All 616 participants who developed PD were matched to up to five controls by age, and 565 were matched to controls by age and confounder scores (based on a modified version of the Charlson comorbidity index).
Regular NSAID use was defined as more than 60 times in a year, based on the responses to annual questionnaires.
Rather than being protective, regular use of non-aspirin NSAIDs for 1-2 years was associated with a 35% increase in the likelihood of PD relative to nonregular use in both the age-matched and confounder-matched groups.
However, this association disappeared when the analysis was restricted to NSAID use at least 5 years before the date of PD diagnosis. Furthermore, 5 years or more of regular non-aspirin NSAID use before diagnosis did not influence the likelihood of having PD.
This implies "confounding by indication," say Driver et al - in other words, they believe that the men received NSAIDs for PD-related pain that appeared prior to a formal diagnosis.
Regular aspirin use was only associated with PD in the confounder-matched group, with 5-9 versus 0-4 years of use prior to the date of PD diagnosis in cases associated with a 38% increase in the likelihood of having PD.
There was no evidence for a reduced risk of PD with regular use of either aspirin or non-aspirin NSAIDs, the researchers note in the BMJ.
They conclude: "Considering the substantial potential side effects of chronic NSAID use, the totality of available data is not sufficient to recommend NSAIDs for prevention of PD."
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By Eleanor McDermid