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 I I 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% Cl 0.78, 1.05). The pooled risk ratio of PD for aspirin (acetylsalicylic acid) users was 1.08 (95% Cl 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% Cl for men was suggestive of a slight risk reduction.