Two painkillers fail to slow Alzheimer's

By LINDSEY TANNER : AP Medical Writer
Jun 3, 2003 : 7:22 pm ET

CHICAGO -- Two popular pain relievers failed to slow the progression of Alzheimer's disease in people with mild to moderate mental decline, a study found, dampening hopes that widely used anti-inflammatory drugs might be an effective treatment.

After a year on the prescription drug Vioxx or over-the-counter Aleve, known generically as naproxen, patients were no better off than those taking dummy pills.

The results "are not encouraging for those who are in need of an effective immediate intervention," said Georgetown University's Dr. Paul Aisen, who led the study.

Despite the disappointing findings in people already diagnosed with Alzheimer's, nonsteroidal anti-inflammatory drugs such as those studied could still prove effective in preventing the disease in the first place, said Neil Buckholtz, chief of the National Institute on Aging's division of dementias in aging. The institute helped pay for the study and is sponsoring continuing research on the theory.

Some previous studies have suggested that certain pain relievers might slow or prevent Alzheimer's. The theory is based in part on evidence that some people who use a lot of anti-inflammatory medication, such as those with arthritis, seem to be less prone to Alzheimer's.

Researchers believe that inflammation contributes to the neurological damage found in the mind-robbing disease.

But the earlier studies were less rigorous than Aisen's research, which compared anti-inflammatory drugs and dummy pills head-to-head.

His study involved 351 men and women about 74 years old on average with Alzheimer's symptoms. The findings appear in Wednesday's Journal of the American Medical Association.

NIA researcher Lenore Launer said in an accompanying editorial that it might be that when Alzheimer's has progressed to the point of causing symptoms, it is too far advanced to be affected by anti-inflammatory drugs.

"Full-blown Alzheimer's disease exhibits extensive brain pathology," Launer said, adding, "Slowing the progression at that stage may be too late."

Many people hoping to reduce Alzheimer's symptoms take drugs such as Vioxx and Aleve but should stop because they can cause serious gastrointestinal problems, Aisen said. Six people in the study developed serious gastrointestinal bleeding.

Patients took 25 milligrams once daily of Vioxx -- a standard dose -- or 220 mgs twice-daily of Aleve -- a relatively low dose -- for a year. They were compared to patients taking a placebo.

Northwestern University professor Linda Van Eldik said it is possible that higher doses would have a beneficial effect and that other anti-inflammatory drugs would have better results.

"It would have been great if it had worked, but I don't think it's closing the door" to the use of such drugs against Alzheimer's, said Van Eldik, a member of the Alzheimer's Association's scientific advisory council.

Naproxen and other older nonsteroidal anti-inflammatory drugs target two enzymes involved in inflammation. Vioxx is a newer painkiller called a cox-2 inhibitor that targets only one of the enzymes.