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Patients with RA may be at higher risk for epilepsy
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Patients with rheumatoid arthritis had a higher incidence of epilepsy compared to the general population, according to a study of the National Health Insurance Research Database in Taiwan.
Researchers identified 32,005 patients with rheumatoid arthritis and 32,005 enrollees matched for age and sex from the database between 2000 and 2011. Patients with a history of epilepsy or with incomplete medical records were excluded. Women comprised 77.4% of the RA cohort, and 61.4% were older than age 50 years.
Other patient data was identified through ICD-9 codes, including the presence of diabetes, hyperlipidemia, head injury, coronary artery disease (CAD), COPD, stroke, and autoimmune disease. Pharmacological data collected included the use of NSAIDs, corticosteroids, aspirin, opioids and biologic therapies.
Overall, the incidence of epilepsy was 1.27 times higher per 1,000 person-years in patients with RA compared to enrollees without RA. djustments for age, sex, comorbidities and medication use, an increased risk for epilepsy remained in the patients with RA, and the risk increased with age. A 1.45-fold increased risk was seen in patients with RA who were between the ages of 50 and 64 years, and a 2.12-fold increase was seen in patients with RA over age 65 years.
The risk for developing epilepsy was higher after adjusting for comorbidities overall, including patients with diabetes, hypertension, CAD, head injury, COPD and stroke.
In overall analysis, the risk was 1.6 times higher for men compared to women, but compared to women without RA, women with RA were 1.59 times more likely to develop epilepsy.
A significantly higher risk (adjusted HR 2.37) for epilepsy was seen in patients with RA who had used NSAIDs for up to 560 days, but the risk decreased with length HR of 1.81 561 1,180 days and further decreased to 0.37 after 1,181 days of NSAID use.
“RA patients are encouraged to seek treatment for pain relief as early as possible to help lower the risk of epilepsy, thereby slowing epilepsy progression with a longer period of NSAID use,” the researchers concluded. “Based on the limitations, additional clinical studies are warranted to investigate the underlying mechanisms of the association between RA and epilepsy.” – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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