NSAID use and the risk of Parkinson's disease: systematic review and meta-analysis of observational studies.
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.
Samii
Ali
A
Department of Neurology, University of Washington, and the Seattle VA Parkinson Disease Research Education and Clinical Center, Seattle, Washington, USA. asamii@u.washington.edu
Etminan
Mahyar
M
Wiens
Matthew O
MO
Jafari
Siavash
S
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016017:Odds Ratio; D010300:Parkinson Disease / Q000453:epidemiology* / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012727:Sex Characteristics
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018696:Neuroprotective Agents; D001241:Aspirin; D007052:Ibuprofen