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Abstract

Background:

Neuroinflammation may contribute to the pathogenesis of Parkinson disease (PD). Use of nonsteroidal anti-inflammatory drugs (NSAID) in general, and possibly ibuprofen in particular, has been shown to be related to lower PD risk in previous epidemiologic studies.

Methods:

We prospectively examined whether use of ibuprofen or other NSAIDs is associated with lower PD risk among 136,197 participants in the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS) free of PD at baseline (1998 for NHS and 2000 for HPFS). NSAIDs use was assessed via questionnaire. Results were combined in a meta-analysis with those of published prospective investigations.

Results:

We identified 291 incident PD cases during 6 years of follow-up. Users of ibuprofen had a significantly lower PD risk than nonusers (relative risk [RR], adjusted for age, smoking, caffeine, and other covariates = 0.62; 95% confidence interval [CI] 0.42–0.93; p = 0.02). There was a dose–response relationship between tablets of ibuprofen taken per week and PD risk (p trend = 0.01). In contrast, PD risk was not significantly related to use of aspirin (RR = 0.99; 95% CI 0.78–1.26), other NSAIDs (RR = 1.26; 95% CI 0.86–1.84), or acetaminophen (RR = 0.86; 95% CI 0.62–1.18). Similar results were obtained in the meta-analyses: the pooled RR was 0.73 (95% CI 0.63–0.85; p < 0.0001) for ibuprofen use, whereas use of other types of analgesics was not associated with lower PD risk.

Conclusions:

The association between use of ibuprofen and lower PD risks, not shared by other NSAIDs or acetaminophen, suggests ibuprofen should be further investigated as a potential neuroprotective agent against PD.

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Supplementary Material

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Information & Authors

Information

Published In

Neurology®
Volume 76Number 10March 8, 2011
Pages: 863-869
PubMed: 21368281

Publication History

Received: March 6, 2010
Accepted: October 4, 2010
Published online: March 2, 2011
Published in print: March 8, 2011

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Disclosure

Dr. Gao has received research support from the NIH/NINDS. Dr. Chen has received intramural funding from the NIH. Dr. Schwarzschild has received research support from the NIH/NINDS, the US Department of Defense, the Michael J. Fox Foundation, the Parkinson Disease Foundation, the RJG Parkinson's Disease Foundation, the American Parkinson Disease Association, and the American Federation for Aging Research. Dr. Ascherio serves on a scientific advisory board for the Michael J. Fox Foundation; serves on the editorial boards of Neurology®, Annals of Neurology, and the American Journal of Epidemiology; has received speaker honoraria from Merck Serono; and receives research support from the NIH, the US Department of Defense, and the Michael J. Fox Foundation.

Authors

Affiliations & Disclosures

Xiang Gao, MD, PhD
From the Channing Laboratory (X.G., A.A.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston; Departments of Nutrition (X.G., A.A.) and Epidemiology (A.A.), Harvard University School of Public Health, Boston, MA; Epidemiology Branch (H.C.), National Institute of Environmental Health Sciences, Research Triangle Park, NC; and Department of Neurology (M.A.S.), Massachusetts General Hospital, Boston.
Honglei Chen, MD, PhD
From the Channing Laboratory (X.G., A.A.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston; Departments of Nutrition (X.G., A.A.) and Epidemiology (A.A.), Harvard University School of Public Health, Boston, MA; Epidemiology Branch (H.C.), National Institute of Environmental Health Sciences, Research Triangle Park, NC; and Department of Neurology (M.A.S.), Massachusetts General Hospital, Boston.
Michael A. Schwarzschild, MD, PhD
From the Channing Laboratory (X.G., A.A.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston; Departments of Nutrition (X.G., A.A.) and Epidemiology (A.A.), Harvard University School of Public Health, Boston, MA; Epidemiology Branch (H.C.), National Institute of Environmental Health Sciences, Research Triangle Park, NC; and Department of Neurology (M.A.S.), Massachusetts General Hospital, Boston.
Alberto Ascherio, MD, DrPH
From the Channing Laboratory (X.G., A.A.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston; Departments of Nutrition (X.G., A.A.) and Epidemiology (A.A.), Harvard University School of Public Health, Boston, MA; Epidemiology Branch (H.C.), National Institute of Environmental Health Sciences, Research Triangle Park, NC; and Department of Neurology (M.A.S.), Massachusetts General Hospital, Boston.

Notes

Address correspondence and reprint requests to Dr. Xiang Gao, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, 181 Longwood Ave., Boston, MA 02115 [email protected]
Study funding: Supported by NIH/NINDS grant R01 NS048517, NIH K24NS060991, and in part by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences. None of the sponsors participated in the design of this study or in the collection, analysis, or interpretation of the data.

Author Contributions

Statistical analysis was conducted by Dr. Gao.

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