May 5, 2008 -- The long-term use of ibuprofen and possibly other nonsteroidal anti-inflammatory pain relievers may help protect against Alzheimer's disease, but it is still not clear if the risks outweigh the potential benefits.
Ibuprofen users seemed to derive the most protection after five years of use, but researcher Steven C. Vlad, MD, of Boston University School of Medicine, says it is far too soon to recommend the use of this or any other NSAID to lower Alzheimer's risk.
"I would not advise patients to start taking an NSAID to prevent Alzheimer's," Vlad tells WebMD. "There are too many known risks associated with this class of medications, and we would need a lot more research to figure out the risk-benefit ratio."
NSAIDs and Alzheimer's
Researchers have long sought to prove that NSAIDs prevent or delay Alzheimer's by reducing the inflammation that is thought to play a major role in the disease.
But the investigations have been contradictory, with some suggesting a protective benefit for NSAID use and others showing no benefit.
In the newly published study, Vlad and colleagues examined the prescription records of more than 49,000 U.S. veterans with Alzheimer's and almost 197,000 age-matched veterans without the disease.
The average age of the people included in the study was 74; 97% were male.
Overall, the regular use of nonsteroidal pain relievers for more than five years was associated with a 24% reduction in the risk of Alzheimer's disease.
Use for less than five years was not as protective, and some of the pain relievers did not appear to be protective at all.
The Cox-2 inhibitors Celebrex and Vioxx showed no evidence of benefit. Vioxx is no longer available in the U.S.
"In our study ibuprofen was protective, but the Cox-2s weren't," he says. "For some of the other drugs we looked at, it wasn't really clear."
Risks vs. Benefits
Longtime Alzheimer's researcher David A. Bennett, MD, of Chicago's Rush University calls the findings "one more piece of evidence" suggesting that at least some NSAIDs help protect against Alzheimer's.
But he adds that more study is needed to confirm the findings and determine if the benefits of long-term use outweigh the potential harm.
Regular, long-term use of NSAIDs is associated with an increased risk of ulcers and potentially life-threatening stomach bleeding, especially in people over the age of 65.
Bennett directs the Rush Alzheimer's Disease Center and is a professor of neurological sciences.
"I would not prescribe ibuprofen or any NSAID based on the current data," Bennett tells WebMD. "In addition to the safety issues, we really don't know when NSAIDs would have to be used to see this benefit. There are just too many unanswered questions."