Poly Tahmina Nasrin, Islam Md Mohaimenul Rubel, Yang Hsuan-Chia, Li Yu-Chuan Jack
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110, Taiwan.
International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan.
Eur J Clin Pharmacol. 2019 Jan;75(1):99-108. doi: 10.1007/s00228-018-2561-y. Epub 2018 Oct 2.
Several studies have explored the impact of non-steroidal anti-inflammatory drugs (NSAIDs) and the risk of Parkinson disease (PD). However, the extent to which NSAIDs may increase or decrease the risk of PD remains unresolved. We, therefore, performed a meta-analysis of relevant studies to quantify the magnitude of the association between NSAID use and PD risk in the elderly population.
The electronic databases such as PubMed, EMBASE, Scopus, Google Scholar, and Web of Science were used to search the relevant articles published between January 1990 and December 2017. Large (n ≥ 1000) observational design studies with a follow-up at least 1 year were considered. Two authors independently extracted information from the included studies. Random effect model was used to calculate risk ratios (RRs) with 95% confidence interval (Cl).
A total of 17 studies with 2,498,258 participants and nearly 14,713 PD patients were included in the final analysis. The overall pooled RR of PD was 0.95 (95%CI 0.860-1.048) with significant heterogeneity (I = 63.093, Q = 43.352, p < 0.0001). In the subgroup analysis, the overall pooled RR of PD was 0.90 (95%CI 0.738-1.109), 0.96 (95%CI 0.882-1.055), and 0.99 (95%CI 0.841-0.982) from the studies of North America, Europe, and Asia. Additionally, long-term use, study design, individual NSAID use, and risk of PD were also evaluated.
Despite the neuroprotective potential of NSAIDs demonstrated in some experimental studies, our findings suggest that there is no association between NSAIDs and the risk of Parkinson disease at the population level. Until further evidence is established, clinicians need to be vigilant ensuring that the use of NSAIDs remains restricted to their approved anti-inflammatory and analgesic effect.
多项研究探讨了非甾体抗炎药（NSAIDs）的影响及帕金森病（PD）的风险。然而，NSAIDs可能增加或降低PD风险的程度仍未解决。因此，我们对相关研究进行了荟萃分析，以量化老年人群中使用NSAIDs与PD风险之间关联的程度。
使用PubMed、EMBASE、Scopus、谷歌学术和科学网等电子数据库检索1990年1月至2017年12月发表的相关文章。考虑样本量较大（n≥1000）且随访至少1年的观察性设计研究。两位作者独立从纳入研究中提取信息。采用随机效应模型计算风险比（RRs）及95%置信区间（Cl）。
最终分析纳入了17项研究，共2498258名参与者和近14713例PD患者。PD的总体合并RR为0.95（95%CI 0.860 - 1.048），存在显著异质性（I = 63.093，Q = 43.352，p < 0.0001）。在亚组分析中，来自北美、欧洲和亚洲的研究中，PD的总体合并RR分别为0.90（95%CI 0.738 - 1.109）、0.96（95%CI 0.882 - 1.055）和0.99（95%CI 0.841 - 0.982）。此外，还评估了长期使用、研究设计、个体NSAIDs使用情况以及PD风险。
尽管一些实验研究表明NSAIDs具有神经保护潜力，但我们的研究结果表明，在人群水平上NSAIDs与帕金森病风险之间无关联。在有进一步证据之前，临床医生需要保持警惕，确保NSAIDs的使用仍限于其已获批的抗炎和镇痛作用。
