Use of Selective Cyclooxygenase-2 Inhibitors, Other Analgesics, and Risk of Glioma

PLoS One. 2016 Feb 12;11(2):e0149293. doi: 10.1371/journal.pone.0149293. eCollection 2016.


Background: Selective cyclooxygenase-2 (COX-2) inhibitors are analgesic, antipyretic, and anti-inflammatory drugs. They have been found to inhibit the development of glioma in laboratory investigations. Whether these drugs reduce the risk of glioma incidence in humans is unknown.

Methods: We conducted a matched case-control analysis using the U.K.-based Clinical Practice Research Datalink (CPRD). We identified 2,469 cases matched to 24,690 controls on age, sex, calendar time, general practice, and number of years of active history in the CPRD prior to the index date. We conducted conditional logistic regression analyses to determine relative risks, estimated as odds ratios (ORs) with 95% confidence intervals (CIs) of glioma in relation to use of selective COX-2 inhibitors, adjusted for several confounding variables.

Results: Use of selective COX-2 inhibitors was unrelated to risk of glioma (adjusted OR for 1-9 versus 0 prescriptions = 1.02; 95% CI = 0.92-1.13, 10-29 versus 0 prescriptions = 1.01; 95% CI = 0.80-1.28, ≥30 versus 0 prescriptions = 1.16; 95% CI = 0.86-1.55). Trends for increasing numbers of prescriptions for other non-steroidal anti-inflammatory drugs (NSAIDs), and non-NSAID analgesics were also not associated with glioma risk.

Conclusion: Further epidemiologic studies are needed to confirm the null relation of use of selective COX-2 inhibitors to glioma risk and to explain the discrepancy between laboratory investigations and our observational study.

Impact: Use of selective COX-2 inhibitors is unrelated to glioma risk.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Brain / drug effects
  • Brain Neoplasms / epidemiology*
  • Brain Neoplasms / prevention & control
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cyclooxygenase 2 Inhibitors / therapeutic use*
  • Glioma / epidemiology*
  • Glioma / prevention & control
  • Humans
  • Infant
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Young Adult


  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase 2 Inhibitors

Grant support

This study was sponsored by the German Research Foundation [KFO 262/P10 to C.S and M.L.]. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.