Could one of the most consumed painkillers on the market stop
Alzheimer’s? If only, that would be great. However, it’s a little more complex.
Last week The Sun and (of course) the Daily Mail, along with other major news outlets published an article stating that ibuprofen has the potential to ‘wipe
out’ Alzheimer’s. The news orients itself firmly to state that this study is a
significant scientific breakthrough. They know how to stop Alzheimer’s, that is amazing. You can source the paper they are referring
to. This is open access, you can read the study yourself. When we get studies
like this, we expect double-blinded randomly controlled clinical studies that can
give us (hopefully) unbiased results, which can then be replicated to establish
connections. As this is a big disease with which the mechanism and pathology
are very little understood, I would expect big things from this study, and hope
it was more of a review of double-blinded clinical studies rather than one.
The…work
I won’t use the word ‘study’. It is kind of insulting to the
word given the terminology used. The work was misnomer-ly titled: Alzheimer’s Disease Can Be Spare by Non-steroidal Anti-Inflammatory Drugs. What media outlet wouldn’t go crazy over an article with
that title? Not too shockingly the work carried out was not a double-blinded
randomly controlled study, but instead the study looked at the amount of
amyloid-beta protein in the saliva. This is a protein that some researchers believe
to be higher than average in the initial stages of dementia. I would like to
point out, there is no proven connection here between the protein concentration
and the onset of Alzheimer’s disease, this is just a hypothesis. It could be right,
but it could also be wrong. The test was carried out on 23 people who had Alzheimer’s
disease and 31 people acted as a control. I will repeat the title here:
Alzheimer’s
Disease Can Be Spared
by
Nonsteroidal Anti-Inflammatory Drugs
…They appear to have missed off: ‘by using uneven controls
and making a titanic jump to the conclusion with remarkably small sample numbers’.
But hey, that’s the nature of science, sadly. The paper itself doesn’t even
mention ibuprofen, it states ‘non-steroidal anti-inflammatory drugs’ (NSAID)
not specifically ibuprofen as the articles suggest. Nevertheless, the authors
state that NSAIDs appear to be effective for the prevention of the disease. This
was based on testing the subjects and finding an ‘elevated’ level of the
protein in those who are at risk of developing Alzheimer’s when compared to
those who are not at risk. Even after carrying out one test, the researchers
state that these elevated levels are present throughout a subject’s lifespan.
They then go on to suggest that people should be tested at the age of 55 for
elevated amyloid-B protein.
But if that elevated protein level is an indicator of Alzheimer’s
onset, and it is present throughout the person’s life, why wait 55 years to be
tested? You could be tested earlier on and start actual clinically trialled
medical treatments. Again, only 23 people with Alzheimer’s were tested in this
study compared to the other ‘control’ subject. But how do we know any of them
did (or will) go on to develop the disease?
We are unsure if these protein levels change over time, the authors
of this study say it stays throughout life. But, as I stated, if that was true
then you could be tested much earlier on to prevent the disease. This study does
not tell the scientific world, or indeed the people who have Alzheimer’s,
anything new about the disease and how it can be prevented.
Bias
There is also a massive potential for bias in this study. Published
in a peer-reviewed journal (which means someone in this field actually has checked
this work before allowing it to be published), one of the opening gambits of
the article are:
Our grant application to support
the research was rejected when a peer reviewer evaluated it as a “crazy
hypothesis”.
I have genuinely never seen anything like that written in a
published paper that wants to be taken seriously – and I have read a hell of a lot
of papers that really should not have been published. This research was carried
out by the researchers and founders at Aurin Biotech, a pharmaceutical company
based in Canada. The paper states that no funding sources were declared, but there
is a massive potential for a conflict of interest as the drug developers themselves
designed and carried out the test.
The Harm
Alzheimer’s is not a nice disease. My grandparents are terrified
of getting it, they have seen their friends die from it and they have friends
currently deteriorating from it. Fear is what drives most of the articles that
I write about in these blogs. Fearmongering to get people to panic and read
their articles is all the media is doing, and people will fall for it. There
are problems with taking NSAIDS for no reason. NSAIDS are linked to various stomach problems and most recently have been linked to an increased risk of heart attacks in some people. It has been recommended they be used with
caution.
Dr McGeer said: 'If they exhibit elevated Abeta42 levels then, that is
the time to begin taking daily ibuprofen to ward off the disease.’
Many people could read these articles and be in fear of Alzheimer’s
so much, they will do anything to prevent it occurring. Pharmaceutical over-the-counter
drugs can’t do harm if they’re developed to help, right? So, I’ll just take 1-2
a day (papers recommendation) and then I won’t get diseases. No, there are
serious adverse health effects for the misuse of medication and
over-the-counter drugs are not exceptions to these risks. There are only three
known drugs recommended by the National Institute for Health and Care Excellence (NICE). These drugs are on the market and shown to be beneficial at slowing
down the progress of early onset Alzheimer’s.
Conclusion
The mammoth amount of irresponsibility carried over by the
media on this one is ridiculous. Articles such as this one where common drugs
are recommended to treat such complex diseases should be approached with
caution and discussed with a doctor. The blame is not solely on the media with
this one, the paper itself is riddled with problems, mostly with the conclusions.
These ‘experts’ have then commented to the media, supporting how NSAIDS will
work in slowing Alzheimer’s progress. The claims made in the article and then propagated
by the media need thoroughly analysing a verifying before being put out to the
general public. I’ll say this again to hammer the point; scientific media
communication is crucial for the understanding of science by the general
public. This requires scientists to be able to clearly communicate results
without the media twisting it as click-bait or irresponsible fear-mongering.
The ‘r’ of The Sun
who wrote this article has a degree in history. Not medical science. Not biology.
Not chemistry. History. How are regulatory bodies allowing this
miscommunication to keep on going and when does it stop?
