Study: NSAIDs Seem to Have No Effect on Parkinson’s Incidence
The use of non-steroidal anti-inflammatory drugs (NSAIDs) seems to have no effect on the incidence of Parkinson’s disease, according to a large retrospective Norwegian study.
Researchers focused on the NSAIDs prescribed most in Norway: diclofenac, ibuprofen, and naproxen.
In the study “NSAID use is not associated with Parkinson’s disease incidence: A Norwegian Prescription Database study,” which was published in PLOS One, researchers at the University of Bergen used the Norwegian Prescription Database to investigate whether NSAID use decreases the incidence of Parkinson’s disease.
Multiple processes have been implicated in the development of Parkinson’s, including those that are neuroinflammatory. NSAIDs are a commonly used anti-inflammatory medication, but previous studies have provided conflicting results regarding whether NSAIDs have an effect on the incidence of Parkinson’s disease.
“The epidemiological evidence of NSAID-use with respect to [Parkinson’s disease] risk is conflicting,” the researchers wrote.
To address this question, the team analyzed data from all prescriptions of NSAIDs, from 2004 to 2017, in the Norwegian Prescription database.
In total, 7,580 individuals (ages ranging from 50 to older than 80) were identified as having received dopaminergic medications — an indicator of a Parkinson’s diagnosis. Analyses were performed on patients who had taken daily doses of NSAIDs for 90 days, and those who had taken them for 365 days. Age was taken into account for both groups.
The results showed no difference in Parkinson’s incidence between patients who had been on NSAIDs for at least 90 days, as compared to those who received NSAIDs for more than a year. Also, no difference was observed in those receiving NSAID only, NSAID combined with aspirin, or aspirin alone. Aspirin (also known as acetylsalicylic acid) is used commonly to reduce inflammation.
A sub-analysis regarding the three most-used NSAIDs — diclofenac, ibuprofen, and naproxen — revealed the results for each therapy were similar to the overall NSAID data, meaning that no decreased Parkinson’s incidence was observed among those who took those particular NSAIDs.
“In this retrospective study, based on the entire Norwegian population, we found no evidence of an association between NSAID use and a decreased incidence of PD [Parkinson’s disease],” the researchers wrote. “Overall we observed no decrease in PD incidence in any of the analyses whether it was for NSAID exposure in general or for diclofenac, ibuprofen or naproxen in particular.”
Some study limitations cited by the team include the lack of information regarding confounding factors, such as smoking and medical history, in the Norwegian Prescription Database. However, researchers noted that previous studies have shown similar habits among NSAID users and non-users with respect to smoking, caffeine, and alcohol consumption. Also, because patients were identified as having Parkinson’s disease based on medication prescriptions, there may have been some included who have atypical parkinsonism.
Nonetheless, the team concluded that the data provide “no evidence that cumulative high exposure to NSAIDs affects the risk of developing [Parkinson’s disease],” they wrote.