Nonsteroidal anti-inflammatory drugs use and risk of Parkinson disease: A dose–response meta-analysis

Previous studies have indicated that nonsteroidal anti-inflammatory drugs (NSAIDs) use is associated with Parkinson disease risk, but presented controversial results. Medline, Embase, Web of Science, and the Cochrane Database were searched update to November 2017. Key data were extracted from eligible studies. A dose–response meta-analysis was conducted for synthesizing data from eligible studies. Fifteen eligible studies were included in this meta-analysis. NSAIDs use was not associated with Parkinson disease risk [relevant risk (RR): 0.06; 95% confidence interval (95% CI), 0.91–1.02]. Subgroup analysis showed that aspirin use (RR: 1.14; 95% CI, 0.98–1.30) or ibuprofen use (RR: 1.01; 95% CI, 0.88–1.17) was not associated with Parkinson disease risk; however, the use of non-aspirin NSAIDs was significantly associated with Parkinson disease risk (RR:0.91; 95% CI, 0.84–0.99). Furthermore, NSAIDs use was not associated with the risk of Parkinson disease in female (RR: 0.99; 95% CI, 0.83–1.17) and male (RR: 1.01; 95% CI, 0.88–1.16). In addition, a dose–response showed per 1 number of prescription incremental increase in NSAIDs use was not associated with the risk of Parkinson disease (RR: 0.96; 95% CI, 0.91–1.02), per 1 year of duration of NSAIDs use incremental increase was not associated with the risk of Parkinson disease (RR: 0.98; 95% CI, 0.92–1.03), and per 1 dosage of NSAIDs use incremental increase was not associated with the risk of Parkinson disease (RR: 0.98; 95% CI, 0.95–1.02). NSAIDs use was not associated with the risk of Parkinson disease. The potency and the cumulative NSAIDs use did not play critical roles.