Anti-inflammatory drug use and progressive supranuclear palsy

Connie Marras; Christopher R Cunningham; Jiayi Hou; James Proudfoot; David G Standaert; Jorge Juncos; David Riley; Stephen G Reich; Deborah Hall; Benzi Kluger; Yvette Bordelon; David R Shprecher; Irene Litvan; for ENGENE-PSP

doi:10.1016/j.parkreldis.2017.11.346

Anti-inflammatory drug use and progressive supranuclear palsy

Parkinsonism Relat Disord. 2018 Mar:48:89-92. doi: 10.1016/j.parkreldis.2017.11.346. Epub 2017 Dec 6.

Authors

Affiliations

¹ The Edmond J Safra Program in Parkinson's Research, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address: cmarras@uhnresearch.ca.
² Division of Movement Disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA.
³ Altman Clinical and Translational Research Institute, University of California San Diego, San Diego, CA, USA.
⁴ Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Department of Neurology, Emory University, Atlanta, GA, USA.
⁶ InMotion, Warrensville Heights, OH, USA.
⁷ Department of Neurology, University of Maryland, Baltimore, MD, USA.
⁸ Department of Neurological Sciences, Rush University, Chicago, ILL, USA; Department of Neurology, University of Colorado, Denver, CO, USA.
⁹ Department of Neurology, University of Colorado, Denver, CO, USA.
¹⁰ Department of Neurology, University of California Los Angeles, CA, USA.
¹¹ Department of Neurology, University of Utah, Salt City, Utah, USA.
¹² Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, CA, USA.

PMID: 29307562
DOI: 10.1016/j.parkreldis.2017.11.346

Abstract

Background: Anti-inflammatory drug use, particularly ibuprofen, has been associated with a lower risk of Parkinson's disease. Microglial activation and inflammatory cytokine expression have been shown to be pathological features of progressive supranuclear palsy. We examined the association between NSAID use and risk of PSP, disease severity and age at onset.

Methods: The ENGENE-PSP multicenter case-control study recruited incident PSP cases who met the NINDS-PSP Society diagnostic criteria and age-, sex- and race-matched controls primarily from the same geographical areas. All subjects underwent standardized interviews to obtain data on demographics, residential history, medication history and lifetime occupational history. NSAID use was specifically queried by telephone interview using a standardized questionnaire.

Results: Information was obtained on anti-inflammatory drug exposure in 276 cases and 278 controls. No association was found between NSAID exposure and risk of PSP, age at onset or rate of change of UPDRS motor subscale, PSP Rating Scale or Mattis Dementia Rating Scale scores. This lack of association persisted when NSAID exposure was measured considering any NSAIDs, ibuprofen only, ASA only or non-ibuprofen, non-aspirin NSAIDs.

Conclusions: These results do not suggest an important association between NSAID use and PSP occurrence or expression. Despite the large size of our study, confidence intervals were wide. To rule out small associations, very large sample sizes will be required.

Keywords: Case-control study; Non-steroidal anti-inflammatory drugs; Progressive supranuclear palsy.

Publication types

Multicenter Study
Research Support, N.I.H., Extramural

MeSH terms

Age Factors
Aged
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Case-Control Studies
Female
Humans
Ibuprofen / therapeutic use*
Male
Middle Aged
Risk Factors
Severity of Illness Index
Supranuclear Palsy, Progressive / drug therapy*

Substances

Anti-Inflammatory Agents, Non-Steroidal
Ibuprofen

Grants and funding

UL1 TR001442/TR/NCATS NIH HHS/United States