Anti-inflammatory drugs and risk of Parkinson disease: A meta-analysis.

[mschild <mmoo@xxxxxxxxxxx>]

http://www.ncbi.nlm.nih.gov/pubmed/20308684
Background/ OBJECTIVE: Anti-inflammatory drugs may prevent Parkinson disease 
(PD) by inhibiting a putative underlying neuroinflammatory process. We tested 
the hypothesis that anti-inflammatory drugs reduce PD incidence and that there 
are differential effects by type of anti-inflammatory, duration of use, or 
intensity of use. METHODS: MEDLINE and EMBASE were searched for studies that 
reported risk of PD associated with anti-inflammatory medications. Random-
effects meta-analyses were used to pool results across studies for each type of 
anti-inflammatory drug. Stratified meta-analyses were used to assess duration- 
and intensity-response. RESULTS: Seven studies were identified that met the 
inclusion criteria, all of which reported associations between nonaspirin 
nonsteroidal anti-inflammatory drugs (NSAIDs) and PD, 6 of which reported on 
aspirin, and 2 of which reported on acetaminophen. Overall, a 15% reduction in 
PD incidence was observed among users of nonaspirin NSAIDS (relative risk [RR] 
0.85, 95% confidence interval [CI] 0.77-0.94), with a similar effect observed 
for ibuprofen use. The protective effect of nonaspirin NSAIDs was more 
pronounced among regular users (RR 0.71, 95% CI 0.58-0.89) and long-term users 
(RR 0.79, 95% CI 0.59-1.07). No protective effect was observed for aspirin (RR 
1.08, 95% CI 0.92-1.27) or acetaminophen (RR 1.06, 95% CI 0.87-1.30). 
Sensitivity analyses found results to be robust. CONCLUSIONS: There may be a 
protective effect of nonaspirin nonsteroidal anti-inflammatory drug use on risk 
of Parkinson disease (PD) consistent with a possible neuroinflammatory pathway 
in PD pathogenesis.

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