On 2017 Feb 20, David Keller commented:

These editorialists actually favor a clinical trial of ibuprofen in patients with Parkinson disease

In 2011, Gao and colleagues published data from 2 large cohorts which demonstrated ibuprofen use was associated with a significant 38% reduction in risk of developing Parkinson disease (PD), with a significant dose response. In addition, they conducted a new meta-analysis including these plus 5 other similar studies, demonstrating a significant 27% reduction in the incidence of PD for persons taking ibuprofen [1]. The accompanying editorial was titled "Is the answer for Parkinson disease already in the medicine cabinet? Unfortunately not". This title seems to contradict the beneficial findings described in Gao's new study and meta-analysis, and the favorable assessment of the design and execution of the studies. The caveat is a familiar one: reduction of risk for PD has been associated with ibuprofen in observational studies only. Treatment cannot be based on observational evidence alone, which cannot eliminate bias and confounding. In the end, the editorialists do conclude that "a clinical trial of ibuprofen, or perhaps a safer PPAR-gamma agonist, may be warranted." A randomized, placebo-controlled clinical trial is necessary to prove that ibuprofen is beneficial before it can be recommended for prevention or treatment of PD.

However, why wait for a PPAR-gamma agonist other than ibuprofen, which is safe enough that millions of patients take it as a non-prescription medicine for pain? Its adverse effects are well-known and can be monitored for during a clinical trial, or prophylaxed. The call by Gao and colleagues for further research on ibuprofen, so well-supported by their findings, has gone unanswered since 2011. Millions of PD patients await proof that any medication can slow the progression of their disease, while a promising possibility may be, indeed, already in the medicine cabinet.

Reference

1: Gao X, Chen H, Schwarzschild MA, Ascherio A. Use of ibuprofen and risk of Parkinson disease. Neurology. 2011 Mar 8;76(10):863-9. doi: 10.1212/WNL.0b013e31820f2d79. PubMed PMID: 21368281; PubMed Central PMCID: PMC3059148.

On 2017 Feb 20, David Keller commented:

These editorialists actually favor a clinical trial of ibuprofen in patients with Parkinson disease

In 2011, Gao and colleagues published data from 2 large cohorts which demonstrated ibuprofen use was associated with a significant 38% reduction in risk of developing Parkinson disease (PD), with a significant dose response. In addition, they conducted a new meta-analysis including these plus 5 other similar studies, demonstrating a significant 27% reduction in the incidence of PD for persons taking ibuprofen [1]. The accompanying editorial was titled "Is the answer for Parkinson disease already in the medicine cabinet? Unfortunately not". This title seems to contradict the beneficial findings described in Gao's new study and meta-analysis, and the favorable assessment of the design and execution of the studies. The caveat is a familiar one: reduction of risk for PD has been associated with ibuprofen in observational studies only. Treatment cannot be based on observational evidence alone, which cannot eliminate bias and confounding. In the end, the editorialists do conclude that "a clinical trial of ibuprofen, or perhaps a safer PPAR-gamma agonist, may be warranted." A randomized, placebo-controlled clinical trial is necessary to prove that ibuprofen is beneficial before it can be recommended for prevention or treatment of PD.

However, why wait for a PPAR-gamma agonist other than ibuprofen, which is safe enough that millions of patients take it as a non-prescription medicine for pain? Its adverse effects are well-known and can be monitored for during a clinical trial, or prophylaxed. The call by Gao and colleagues for further research on ibuprofen, so well-supported by their findings, has gone unanswered since 2011. Millions of PD patients await proof that any medication can slow the progression of their disease, while a promising possibility may be, indeed, already in the medicine cabinet.

Reference

1: Gao X, Chen H, Schwarzschild MA, Ascherio A. Use of ibuprofen and risk of Parkinson disease. Neurology. 2011 Mar 8;76(10):863-9. doi: 10.1212/WNL.0b013e31820f2d79. PubMed PMID: 21368281; PubMed Central PMCID: PMC3059148.