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March 23, 2011

Ibuprofen for Parkinson's

Ibuprofen appears to offer protection against Parkinson's disease. Brain inflammation may be the reason.

A new study shows that the non-steroidal anti-inflammatory drug (NSAID), ibuprofen, may actually reduce one’s risk of developing Parkinson’s. The devastating brain disease is thought to affect 500,000 people in the U.S. While the cause is still poorly understood, the new study adds evidence to the idea that Parkinson’s may be due to inflammation in the brain.

While the mechanism behind the findings isn’t exactly clear, the researchers write that more and more evidence suggests that Parkinson’s may be the result of long term inflammation in the brain.

The researchers followed over 136,000 men and women who did not suffer from Parkinson’s at the beginning of the study. They quizzed the participants about how often and what type of pain medications they took over the years: the medications of interest were ibuprofen (e.g. Advil and Motrin), Aleve, aspirin, and acetaminophen (Tylenol), which is not an NSAID, but the researchers still wished to include it since it’s often used in the same manner as the others. Other lifestyle factors like smoking, age, and diet were also taken into account and controlled for in the study.

After six years of follow-up, 291 of the participants had developed Parkinson’s disease.

Both men and women who used ibuprofen at least twice a week were 38% less likely to develop Parkinson’s over the six years, compared to people who used the other types of painkillers.

Lead author Xiang Gao says in the study’s press release that his team’s findings "suggest that ibuprofen could be a potential neuroprotective agent against Parkinson’s disease, however, the exact mechanism is unknown." He adds that ibuprofen may protect the brain cells that get destroyed when Parkinson’s sets in. While Gao suggests that "use of ibuprofen could help slow the disease’s progression", it’s still too early to make recommendations about using ibuprofen to prevent or treat the disease.

As always, there is a cost/benefit issue at play here, which will need some further investigation. Co-author Alberto Ascherio says that while the drug is "generally perceived as safe, ibuprofen can have side effects, such as increased risk of gastrointestinal bleeding. Whether this risk is compensated by a slowing of the disease progression should be investigated under rigorous supervision in a randomized clinical trial".

While the mechanism behind the findings isn’t exactly clear, the researchers write that more and more evidence suggests that Parkinson’s may be the result of long term inflammation in the brain. They say that while it may have some benefits, over the long run, neuroinflammation can become a vicious cycle that may lead to destruction of cells in the substantia nigra, the area of the brain that is affected in Parkinson’s. But the researchers still are not sure what makes ibuprofen different from other NSAIDS in its potential role in reducing the risk of Parkinson’s. The possibility that a relatively inexpensive drug might benefit Parkinson’s patients in the future is exciting, and the researchers write that clinical trials in patients in the early stages of Parkinson’s will be an important next step.

The research was carried out by researchers at Harvard University and published in the March 8, 2011 issue of Neurology.

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