People with rheumatoid arthritis have a 1.74 times higher risk of Parkinson’s disease

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Important points:

  • Seropositive rheumatoid arthritis patients are at increased risk of developing Parkinson’s disease, researchers said.
  • The researchers concluded that physicians treating patients with rheumatoid arthritis should be aware of this increased risk.

Data published in 2019 show that people with rheumatoid arthritis have an almost 1.5-fold higher risk of developing Parkinson’s disease compared to those without rheumatoid arthritis. JAMA Neurology.

“The etiology of Parkinson’s disease (PD) is largely unknown, except for a few cases caused by rare genetic mutations.” jihoon Kang M.D., PhDs and colleagues at Hung Shin University School of Medicine in Busan, South Korea, write: “Multiple clinical and experimental lines of evidence implicate autoimmunity in the activation of microglia and monocytes, which play a central role in the initiation and amplification of brain inflammation.”

Data obtained from Kang J et al. JAMA Neurology. 2023; doi:10.1001/jamaneurol.2023.0932.

To explore a possible relationship between rheumatoid arthritis and Parkinson’s disease, Kang and colleagues analyzed data from the National Health Insurance Corporation of Korea on patients diagnosed with rheumatoid arthritis between 2010 and 2017. Patients were identified by diagnostic code and prescription for disease-modifying antirheumatic drugs. .

Individuals under the age of 40 who are enrolled in the Rare Intractable Disease (RID) program, present with a disease that is not rheumatic in nature, have a history of Parkinson’s disease, and have been diagnosed with Parkinson’s disease within 1 year of enrollment. In addition, missing person data or data that were discordant in the control group were excluded.

The primary outcome was a diagnosis of Parkinson’s disease. For certification, patients had to have a formal diagnosis from a neurologist. Patients were followed for 1 year after diagnosis of rheumatoid arthritis until a diagnosis of Parkinson’s disease or study termination on December 31, 2019.

A total of 328,080 patients were included in the analysis, of which 1,093 were diagnosed with Parkinson’s disease. The researchers demonstrated that RA patients had a 1.74-fold increased risk of developing Parkinson’s disease compared to controls (95% CI, 1.52 to 1.99). Furthermore, seropositive RA patients were more likely to develop Parkinson’s disease (adjusted HR = 1.95; 95% CI, 1.68-2.26). Conversely, seronegative RA patients were less likely to develop Parkinson’s disease (aHR = 1.2; 95% CI, 0.91-1.57).

“We found that RA was associated with an increased risk of PD. [seropositive RA] resulting in an increased risk of PD,” write Kang et al. “…the results of this study suggest that physicians caring for patients with RA should be aware of the increased risk of PD, and that early motor manifestations of PD in patients with RA without synovitis should be accompanied by prompt referral to a neurologist. suggesting that a referral should be considered.”

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