Role of Nonsteroidal Anti-Inflammatory Drugs as a Protective Factor in Alzheimer's Disease: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 39690983 · doi:10.4103/ni.ni_1073_22
What was done
A systematic review and meta-analysis was conducted across PubMed, Web of Science, and Embase to evaluate whether nonsteroidal anti-inflammatory drugs (NSAIDs) treat or protect against Alzheimer's disease (AD). The authors included randomized clinical trials (RCTs) evaluating NSAIDs on AD diagnosis or cognitive function in participants without AD at baseline. Outcomes assessed were Mini-Mental State Examination (MMSE) scores and hazard ratios (HR) for AD incidence.
What was found
Nine RCTs were included in the meta-analysis: - MMSE score difference pooled effect size: -0.06 (95% CI: -0.22 to 0.10; p = 0.47). - MMSE score pooled effect size: -0.0036 (95% CI: -0.0320 to 0.0248; p = 0.87). - Pooled hazard ratio for AD incidence (random-effects model): 1.20 (95% CI: 0.95 to 1.51; p = 0.15). All pooled findings were non-significant.
Why it matters
Despite observational hypotheses suggesting that anti-inflammatory agents might reduce neuroinflammation in AD, pooled randomized trial data demonstrate that NSAIDs offer neither therapeutic cognitive benefit nor prevention against developing AD.
Limits
The analysis is restricted to nine RCTs, and the abstract does not report the total participant count, specific NSAID drug classes, dosing regimens, treatment duration, or assessment of study heterogeneity and publication bias.
Cited by
- contradicts Chronic use of NSAIDs or H2-blocking acid reducers is associated with a dramatic increased risk of dementia and stroke.