Anti-inflammatory drugs and risk of Parkinson disease A meta-analysis
Anti-inflammatory drugs and risk of Parkinson disease A meta-analysis
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DOI：
10.1212/wnl.0b013e3181d5a4a3
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发表时间：
2010-03-23
期刊：
影响因子：
9.9
通讯作者：
Power, Melinda C.
中科院分区：
文献类型：
--
作者：
Gagne, Joshua J.;Power, Melinda C.
背景/目的：抗炎药可能通过抑制潜在的神经炎症过程来预防帕金森病（PD）。我们测试的假设，抗炎药降低PD的发病率，并有不同的影响类型的抗炎药，使用的持续时间，或强度的use.Methods：MEDLINE和EMBASE进行了搜索的研究，报告与抗炎药物相关的PD的风险。使用随机效应荟萃分析来汇总每种类型抗炎药的研究结果。分层荟萃分析被用来评估持续时间和强度respons.Results：7项研究被确定为符合纳入标准，所有这些报告之间的关联nonaspirin非甾体抗炎药（NSAID）和PD，其中6个报告阿司匹林，其中2个报告对乙酰氨基酚。总体而言，在非阿司匹林NSAIDS使用者中观察到PD发生率降低15%（相对风险[RR] 0.85，95%置信区间[CI] 0.77-0.94），使用布洛芬观察到类似的效果。非阿司匹林NSAID的保护作用在常规使用者（RR 0.71，95% CI 0.58-0.89）和长期使用者（RR 0.79，95% CI 0.59-1.07）中更为明显。阿司匹林（RR 1.08，95% CI 0.92-1.27）或对乙酰氨基酚（RR 1.06，95% CI 0.87-1.30）未观察到保护作用。敏感性分析发现结果是robust.Conclusions：可能有保护作用的非阿司匹林非甾体类抗炎药的使用对帕金森病（PD）的风险与可能的神经炎症通路在PD发病机制一致。神经病学（R）2010;74：995-1002
Background/Objective: Anti-inflammatory drugs may prevent Parkinson disease (PD) by inhibiting a putative underlying neuroinflammatory process. We tested the hypothesis that anti-inflammatory drugs reduce PD incidence and that there are differential effects by type of anti-inflammatory, duration of use, or intensity of use.Methods: MEDLINE and EMBASE were searched for studies that reported risk of PD associated with anti-inflammatory medications. Random-effects meta-analyses were used to pool results across studies for each type of anti-inflammatory drug. Stratified meta-analyses were used to assess duration-and intensity-response.Results: Seven studies were identified that met the inclusion criteria, all of which reported associations between nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) and PD, 6 of which reported on aspirin, and 2 of which reported on acetaminophen. Overall, a 15% reduction in PD incidence was observed among users of nonaspirin NSAIDS (relative risk [RR] 0.85, 95% confidence interval [CI] 0.77-0.94), with a similar effect observed for ibuprofen use. The protective effect of nonaspirin NSAIDs was more pronounced among regular users (RR 0.71, 95% CI 0.58-0.89) and long-term users (RR 0.79, 95% CI 0.59-1.07). No protective effect was observed for aspirin (RR 1.08, 95% CI 0.92-1.27) or acetaminophen (RR 1.06, 95% CI 0.87-1.30). Sensitivity analyses found results to be robust.Conclusions: There may be a protective effect of nonaspirin nonsteroidal anti-inflammatory drug use on risk of Parkinson disease (PD) consistent with a possible neuroinflammatory pathway in PD pathogenesis. Neurology (R) 2010;74:995-1002