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- NSAIDs -

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NSAIDs (non-steroidal anti-inflammatory drugs)

See also Inflammation,

Rheumatoid Arthritis Signaling Protein Reverses Alzheimer's Disease in Mouse Model
ScienceDaily (Aug. 23, 2010)
A signaling protein released during rheumatoid arthritis dramatically reduced Alzheimer's disease pathology and reversed the memory impairment of mice bred to develop symptoms of the neurodegenerative disease, a new study by the University of South Florida reports. Researchers found that the protein, GM-CSF, likely stimulates the body's natural scavenger cells to attack and remove Alzheimer's amyloid deposits in the brain. The study appears online in the Journal of Alzheimer's Disease. People with rheumatoid arthritis, a chronic disease leading to inflammation of joints and surrounding tissue, are less likely than those without arthritis to develop Alzheimer's. While it was commonly assumed that non-steroidal anti-inflammatory drugs may help prevent onset and progression of Alzheimer's disease, recent NSAID clinical trials proved unsuccessful for patients with Alzheimer's...

Can anti-inflammatory drugs prevent Alzheimer’s disease?

One of the hallmarks of Alzheimer’s disease is inflammation in the brain, but whether it is a cause or an effect of the disease is not yet known. Epidemiologic evidence strongly suggests that anti-inflammatory agents, such as prednisone (a steroid) and the popular pain relievers known as non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and indomethacin are associated with a decreased risk of Alzheimer’s. Studies in animal models of Alzheimer’s suggest that an NSAID can limit plaque production in the mouse brain.

However, results of a study that compared the effects of prednisone versus a placebo (inactive pill) on people who had been diagnosed with Alzheimer’s found no difference in cognitive decline between the prednisone and placebo treatment groups. Thus, a low-dose regimen of prednisone does not seem to be useful in treating Alzheimer’s disease.

A report in the Journal of the American Medical Association found that two popular NSAIDs, naproxen (Aleve) and the prescription arthritis painkiller rofecoxib (Vioxx), did nothing to slow the progression of Alzheimer’s disease in people with mild to moderate decline. However, previous studies suggest that NSAIDs may help to prevent Alzhiemer’s disease.

There is evidence that these or related drugs can reduce the risk of developing the illness in the first place if given to people before the onset of symptoms. A large study that followed nearly 7,000 patients for an average of 6.8 years found that people who did not use NSAIDs had a nearly five times greater risk of developing the disease than those who used NSAIDs long-term (24 months or more of cumulative use). People who used NSAIDs for more than one but less than 24 months also had a decreased risk of developing Alzheimer’s. The risk did not vary according to age. These data provide perhaps the most convincing evidence to date that NSAIDs may be useful in the prevention of Alzheimer’s disease.

However, a large government study designed to test whether the anti-inflammatory drugs naproxen (an NSAID sold as Aleve) or Celebrex (a pain reliever related to Vioxx and known as a COX-2 inhibitor) was halted after researchers noted that these drugs may cause an increased risk of heart attacks and strokes. Researchers had long known that NSAIDs are associated with gastrointestinal problems, including bleeding ulcers and with kidney problems, but the heart complications present an additional potential danger. These drugs must be used with caution, and only under a doctor’s supervision.

More research is needed on the safety of the various anti-inflammatory drugs and their possible benefits for treating or preventing Alzheimer’s disease. It is possible that those with Alzheimer’s who take different anti-inflammatories or different doses might show benefits. More studies of NSAIDs are under way. Drugs that work against toxic amyloid, the substance that contributes to plaque buildup and that is thought to be key to Alzheimer’s, are also under investigation.

Use of Non-Steroidal Anti-Inflammatory Drugs Suspended in Large Alzheimer’s Disease Prevention Trial. National Institutes of Health, http://www.nih.gov/news/pr/dec2004/od-20.htm

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