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April 15, 2005

Ibuprofen Prevents Parkinson's?

From Medscape Medical News (subscription sometimes required)

Ibuprofen May Protect Against Parkinson's Disease
Paula Moyer, MA

April 14, 2005 (Miami Beach) — Ibuprofen taken daily or weekly may protect users from developing Parkinson's disease, according to investigators who presented their findings here today at the 57th annual meeting of the American Academy of Neurology.

"Ibuprofen users were 35% less likely to develop Parkinson's disease than nonusers," said senior investigator Alberto Ascherio, MD, DrPH, during a press briefing. He stressed that he and his coinvestigators only saw this effect in patients who took ibuprofen and not in those who took aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Dr. Ascherio is an associate professor of nutrition and epidemiology at Harvard School of Public Health in Boston, Massachusetts.

Earlier research has shown that neuronal inflammation is involved in the pathogenesis of Parkinson's disease and that, conversely, NSAIDs may be protective.

Therefore, in a study funded by the Michael J. Fox Foundation for Parkinson's Research and the National Institute for Neurologic Diseases and Stroke, the investigators examined the relationship between ibuprofen use in the 146,565 participants of the American Cancer Society's Cancer Prevention Study II Nutrition Cohort. They also attempted to determine if the benefit extended to aspirin, other NSAIDs, and acetaminophen.

The investigators identified patients who had developed Parkinson's disease between 1992, the year of the study's commencement, and 2000. The participants self-reported the diagnosis, and the investigators either contacted the treating neurologists or reviewed the participants' medical records to confirm the diagnosis.

During 1.25 million person-years of follow-up, 413 people developed Parkinson's disease. Compared with nonusers, ibuprofen users had a relative risk (RR) of 0.65 (P = .005). These results were maintained when the investigators adjusted for age, sex, and smoking status.

Those who used ibuprofen less frequently than two times per week were 27% less likely to develop Parkinson's disease; those who used it two to fewer than seven times per week had a risk reduction of 28%. Daily users had a 39% risk reduction (P trend = .03). The duration of treatment with ibuprofen was not significant.

When the investigators analyzed the relationship between the development of Parkinson's disease and aspirin, other NSAIDs, and acetaminophen, they found no significant associations between these medications and the development of Parkinson's disease.

When asked why the benefits did not extend to aspirin or other NSAIDs, Dr. Ascherio acknowledged that considerably more people could be using ibuprofen than other medications, and that the finding could be a statistical anomaly. However, he also suggested that there may be an ibuprofen-specific effect against Parkinson's disease, such as protection against glutamate toxicity or amyloid deposition. He and his coinvestigators will continue to follow the patients for at least two years to see if they can elucidate the specific protective mechanism.

Physicians should not be surprised that ibuprofen was protective, but rather that the benefit was specific to this drug and was not found with other NSAIDs, according to Walter Rocca, MD, professor of epidemiology and neurology at the Mayo Clinic in Rochester, Minnesota.

"The literature suggests that inflammation and inflammatory processes are involved in Parkinson's disease," said Dr. Rocca, who was not involved in the study. "So the idea that an anti-inflammatory could slow or interfere with that process makes sense. When the mouse model of Parkinson's disease is used, an inflammatory process is evident."

One study limitation is that because ibuprofen is an over-the-counter medication, the so-called nonusers "could have taken ibuprofen years ago," Dr. Rocca said. "Therefore, a short-term clinical study might not give complete data." Long-term data would be necessary to more fully discern users and nonusers, he said.

Reviewed by Gary D. Vogin, MD

Hmmm... So if I take like one 200mg pill a day it will reduce my headaches, back and knee pain and keep my short-term memory. Sounds like a plan.

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