Non-Steroidal Anti-Inflammatory Drug Use and the Risk of Parkinsons Disease

Background: Experimental evidence supports a preventative role for non-steroidal anti-inflammatory drugs (NSAIDs) in Parkinson’s disease (PD). Methods: We investigated associations between use of aspirin, nonaspirin NSAIDs, and acetaminophen and PD in a large population-based casecontrol study using Danish health and pharmacy registries. We identified 1,931 PD cases reported in hospital or outpatient clinic records who had received a primary diagnosis of PD between 2001 and 2006, and 9,651 ageand sex-matched controls from the Danish population register. Prescription medication use was documented in a pharmacy database covering all residents of Denmark since 1995. Results: Adjusting for age, sex, use of cardiovascular disease drugs, diagnosis of chronic pulmonary obstructive disorder, and Charlson comorbidity scores, and excluding prescriptions filled within 5 years before diagnosis, we found no evidence for an association between PD and either aspirin use (OR = 0.97; 95% CI 0.82, 1.14) or nonaspirin NSAID use (OR = 0.97; Received: September 24, 2010 Accepted: February 9, 2011 Published online: April 20, 2011 Beate Ritz, MD, PhD Department of Epidemiology, UCLA School of Public Health, Box 951772 650 Charles E. Young Drive Los Angeles, CA 90095–1772 (USA) Tel. +1 310 206 7458, E-Mail britz @ ucla.edu © 2011 S. Karger AG, Basel Accessible online at: www.karger.com/ned D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /1 9/ 20 17 2 :3 2: 24 P M Manthripragada /Schernhammer /Qiu / Friis /Wermuth /Olsen /Ritz Neuroepidemiology 2011;36:155–161 156 different conclusions [5, 6] . The first meta-analysis concluded that ibuprofen may be protective but NSAIDs as a class likely do not modify the risk of PD [6] , while the second meta-analysis, which used more restrictive inclusion criteria, stated that ‘regular and long-term use’ of non-aspirin NSAIDs reduces PD risk [5] . The uncertainty regarding a possible neuroprotective role for NSAIDs as a class or ibuprofen alone stems in large part from differences in how previous human studies grouped or ascertained their data, since medication type, timing of use prior to disease onset, and overall dose may be critical for assessing and interpreting their results. In order to address some of these previous study limitations, we conducted a large population-based case-control study based within the Danish registry that allowed us to ascertain a largely complete record of prescription NSAID and aspirin use (including dose and duration of use) nationwide in Denmark starting in 1995.