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DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS AND RISK OF PARKINSON’S DISEASE: NESTED CASE-CONTROL STUDY OF PEOPLE WITH RHEUMATOID ARTHRITIS
Abstract
Aims
Epidemiological studies have suggested a link between rheumatoid arthritis and Parkinson’s disease (PD). Aim was to evaluate how use of disease-modifying anti-rheumatic drugs (DMARDs) is associated with risk of PD in persons with rheumatoid arthritis.
Methods
Nested nationwide case-control study was conducted within the Finnish Parkinson’s disease (FINPARK) cohort that includes 22,189 Finnish persons who got clinically verified PD diagnosis in 1996-2015. Cases were Finnish persons with PD diagnosed during 1999-2015 and rheumatoid arthritis diagnosed ≥3 years before PD (N=315). Cases were matched with up to seven control persons by age, sex, duration of rheumatoid arthritis and university hospital district (N=1,571). DMARDs were categorised into five classes and data on drug use was identified from the Prescription Register since 1995. Associations were studied with conditional logistic regression adjusted for confounders.
Results
Use of DMARDs was not associated with risk of PD with three-year lag period applied between exposure and outcome, except chloroquine/hydroxychloroquine which associated with decreased risk (adjusted odds ratio 0.74; 95% confidence interval 0.56-0.97). Other DMARDs, including sulfasalazine, methotrexate, gold preparations and immunosuppressants, had no association with risk of PD.
Conclusions
Our results suggest that the previously implied lower risk of PD in people with rheumatoid arthritis is not explained by DMARD use as these drugs in general did not modify the risk of PD among persons with rheumatoid arthritis. Association between chloroquine/hydroxychloroquine and lower risk of PD as well as the possible underlying mechanisms should be further investigated.