TY - JOUR
T1 - Non-steroidal anti-inflammatory drugs and amyotrophic lateral sclerosis
T2 - Results from five prospective cohort studies
AU - Fondell, Elinor
AU - O'Reilly, Éilis J.
AU - Fitzgerald, Kathryn C.
AU - Falcone, Guido J.
AU - McCullough, Marjorie L.
AU - Thun, Michael J.
AU - Park, Yikyung
AU - Kolonel, Laurence N.
AU - Ascherio, Alberto
N1 - Funding Information:
This work was supported by a grant from the National Institute of Neurological Diseases and Stroke, and by grants from the National Cancer Institute. E. Fondell is supported by a grant from the Blanceflor Foundation, Stockholm, Sweden.
PY - 2012/10
Y1 - 2012/10
N2 - Animal and pathological studies suggest that inflammation may contribute to amyotrophic lateral sclerosis (ALS) pathology and that non-steroidal anti-inflammatory drugs (NSAIDs) might be protective. However, there are no prospective data on the relation between NSAID use and ALS risk in humans. The relation between NSAID use and ALS risk was explored in five large prospective cohort studies (the Nurses' Health Study, the Health Professionals Follow-up Study, the Cancer Prevention Study II Nutrition Cohort, the Multiethnic Cohort Study, and the National Institutes of Health AARP Diet and Health Study). Detailed NSAID information was sought from 780,000 participants, 708 of whom developed ALS during follow-up. Cox proportional hazards models were used within each cohort and cohort-specific estimates were pooled with random effects models. Results showed that neither non-aspirin NSAID use, nor aspirin use was associated with ALS risk overall. The multivariable, pooled relative risk was 0.96 (95% CI 0.761.22) among non-aspirin NSAID users compared with non-users. Duration of NSAID use in years and frequency of NSAID use were not associated with ALS risk overall. In conclusion, the results do not support an overall effect of NSAIDs on ALS risk, but because NSAIDs have heterogeneous effects, a role of individual compounds cannot be excluded.
AB - Animal and pathological studies suggest that inflammation may contribute to amyotrophic lateral sclerosis (ALS) pathology and that non-steroidal anti-inflammatory drugs (NSAIDs) might be protective. However, there are no prospective data on the relation between NSAID use and ALS risk in humans. The relation between NSAID use and ALS risk was explored in five large prospective cohort studies (the Nurses' Health Study, the Health Professionals Follow-up Study, the Cancer Prevention Study II Nutrition Cohort, the Multiethnic Cohort Study, and the National Institutes of Health AARP Diet and Health Study). Detailed NSAID information was sought from 780,000 participants, 708 of whom developed ALS during follow-up. Cox proportional hazards models were used within each cohort and cohort-specific estimates were pooled with random effects models. Results showed that neither non-aspirin NSAID use, nor aspirin use was associated with ALS risk overall. The multivariable, pooled relative risk was 0.96 (95% CI 0.761.22) among non-aspirin NSAID users compared with non-users. Duration of NSAID use in years and frequency of NSAID use were not associated with ALS risk overall. In conclusion, the results do not support an overall effect of NSAIDs on ALS risk, but because NSAIDs have heterogeneous effects, a role of individual compounds cannot be excluded.
KW - ALS
KW - Cohort
KW - Epidemiology
KW - NSAID
UR - http://www.scopus.com/inward/record.url?scp=84866101830&partnerID=8YFLogxK
U2 - 10.3109/17482968.2012.703209
DO - 10.3109/17482968.2012.703209
M3 - Review article
C2 - 22871075
AN - SCOPUS:84866101830
SN - 1748-2968
VL - 13
SP - 573
EP - 579
JO - Amyotrophic Lateral Sclerosis
JF - Amyotrophic Lateral Sclerosis
IS - 6
ER -