Effect of non-steroidal anti-inflammatory drugs on risk of Alzheimer's disease: systematic review and meta-analysis of observational studies
Effect of non-steroidal anti-inflammatory drugs on risk of Alzheimer's disease: systematic review and meta-analysis of observational studies
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DOI：
10.1136/bmj.327.7407.128
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发表时间：
2003-07-19
影响因子：
105.7
通讯作者：
Samii, A
中科院分区：
文献类型：
--
作者：
Etminan, M;Gill, S;Samii, A
目的量化所有非类固醇抗炎药(NSAID)使用者和阿司匹林使用者患阿尔茨海默病的风险，并确定使用时间的任何影响。设计对1966至2002年10月间发表的考察非类固醇抗炎药在预防阿尔茨海默病中的作用的观察性研究进行系统回顾和荟萃分析。通过Medline、Embase、国际药学文摘和Cochrane图书馆鉴定的研究。结果9项研究观察了55岁成年人的所有非类固醇抗炎药。6项是队列研究(总共13211名参与者)，3项是病例对照研究(1443名参与者)。非类固醇抗炎药使用者患阿尔茨海默病的合并相对风险为0.72(95%可信区间为0.56至0.94)。短期使用者(1个月)的风险为0.95(0.70~1.29)，中期使用者(主要为24个月)和长期使用者(主要为24个月)的风险分别为0.83(0.65~1.06)和0.27(0.13~0.58)。在8项研究中，阿司匹林使用者的合并相对危险度为0.87(0.70~1.07)。结论非类固醇抗炎药对阿尔茨海默病的发生有一定的保护作用。药物使用的适当剂量和持续时间以及风险与收益的比率仍然不清楚。
ObjectivesTo quantify the risk of Alzheimer's disease in users of all non-steroidal anti-inflammatory drugs (NSAIDs) and users of aspirin and to determine any influence of duration of use.DesignSystematic review and meta-analysis of observational studies published between 1966 and October 2002 that examined the role of NSAID use in preventing Alzheimer's disease. Studies identified through Medline, Embase, International Pharmaceutical Abstracts, and the Cochrane Library.ResultsNine studies looked at all NSAIDs in adults aged > 55 years. Six were cohort studies (total of 13 211 participants), and three were case-control studies (1443 participants). The pooled relative risk of Alzheimer's disease among users of NSAIDs was 0.72 (95% confidence interval 0.56 to 0.94). The risk was 0.95 (0.70 to 1.29) among short term users (< 1 month) and 0.83 (0.65 to 1.06) and 0.27 (0.13 to 0.58) among intermediate term (mostly < 24 months) and long term (mostly > 24 months) users, respectively. The pooled relative risk in the eight studies of aspirin users was 0.87 (0.70 to 1.07).ConclusionsNSAIDs offer some protection against the development of Alzheimer's disease. The appropriate dosage and duration of drug use and the ratios of risk to benefit are still unclear.