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Early Results Indicate Pain Medications Don’t Prevent Alzheimer’s

Wednesday, April 25, 2007

Neither the over-the-counter pain medication naproxen nor the prescription pain reliever celecoxib appears to help prevent Alzheimer’s disease, according to the early results of a study published April 25 in the online edition of Neurology, the scientific journal of the American Academy of Neurology.

The results contradict several earlier, smaller studies that found that sustained use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and celecoxib might protect people against the disease.

Approximately 280 upstate New York residents took part in the study at the University of Rochester Medical Center, one of six sites nationally for the study that included more than 2,100 people. Participants included people age 70 and older who have a relative with the disease but who show no symptoms themselves. In Rochester, people participated from a wide geographic area, from west of Buffalo to the east near Albany, and down to the Pennsylvania border.

The study sought to settle the question of whether common medicines known as cox inhibitors help delay or even prevent the onset of Alzheimer’s disease. Several studies have indicated that people who regularly use medications that inhibit enzymes known as cox-1 or cox-2 for several years may be less likely to get the disease.

The study was launched six years ago as the first large-scale study to test a method to prevent Alzheimer’s disease. The study, known as ADAPT or Alzheimer’s Disease Anti-Inflammatory Prevention Trial, was funded by the National Institute on Aging.

Physicians compared the health of participants who took either naproxen, a traditional medication that inhibits both the cox-2 and cox-1 enzymes; a more potent cox-2 inhibitor, celecoxib; and a placebo, or pill with no active drug. When the study began, scientists planned to give participants the medication for five years, but when concerns arose in late 2004 about the safety of the two medicines, the study design was changed and participants stopped taking the medicine. At that point, participants had taken the medication assigned to them for an average of two years.

Doctors continued to monitor the health of the participants and found that neither treatment was associated with a reduction in Alzheimer’s disease or dementia.

“The bottom line is that there is no evidence at this time that these should be used to treat or prevent Alzheimer’s disease,” said M. Saleem Ismail, M.D., assistant professor of Psychiatry, who served as director of the Rochester site. “But we have learned a great deal thanks to the 2,100 people who participated in this study. It is possible that the medications might have a protective effect if taken years in advance, or if taken for a longer period of time. We hope to address those questions in the future.”

The scientists and physicians are sifting through the data and continuing to monitor the participants in an effort to find out why the results of the study differ from those of other studies that suggested reduced risk of Alzheimer’s disease among people who take NSAIDs over a long period of time.

The study was done through the University’s Alzheimer’s Disease Care, Research, and Education Program, based at Monroe Community Hospital. Overall more than 1,500 people from the Rochester area have taken part in dozens of Alzheimer’s studies that have helped advance treatment for millions of patients around the globe. The University is the leading site for Alzheimer’s treatment throughout western New York, with about 2,500 patients.

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