Nonsteroidal anti-inflammatory drugs (NSAIDs) include naproxen (Aleve) and ibuprofen (Motrin). Epidemiological studies going back decades raise the possibility that they may be protective in Alzheimer’s disease. In 2018, a meta-analysis of 16 such studies seemed concluded that the risk reduction was 20%. This conclusion was not supported by a large randomized placebo-controlled trial using naproxen and Celebrex in adults with a family history of dementia, but some of the cognitive tests seemed to show benefit in the naproxen group.

This uncertainty led a new 2-year double-blind, placebo-controlled prevention trial in “pre-symptomatic” Alzheimer’s. Subjects had positive family history of Alzheimer’s and a mean age of 63 years. Naproxen dose was 220 mg twice a day, the usual over-the-counter dose. There was no benefit over placebo and the naproxen group had more side effects but no serious safety issues.

How many trials are needed before we abandon this approach?

See the editorial by Hershey and Lipton in Neurology April 2019.

Read More