Issue: November 2022
Fact checked byShenaz Bagha

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September 20, 2022
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Patients with AS receiving TNF inhibitors have lower rates of Alzheimer’s disease

Issue: November 2022
Fact checked byShenaz Bagha
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Although ankylosing spondylitis correlates with higher rates of Alzheimer’s disease, patients who receive TNF inhibitors are less likely to develop the neurologic disorder, according to data published in Pharmacological Research.

“There is very little knowledge regarding the neurological morbidity in AS patients, although the latter has been reported to suffer from neurological complications either due to compression of neural tissues caused by joint damage or as a consequence of vasculitis neuropathy,” Abdulla Watad, MD, of Sheba Medical Center, in Israel, and co-authors wrote. “However, there is a lack of large-scale studies assessing the link between neurological disorders and AS.”
To further investigate the link between AS and various neurologic disorders, Wadat and colleagues conducted a retrospective cross-sectional study. The researchers used data from the Clalit Health Services database. Patients with AS were compared in age- and gender-matched groups of varying sizes, depending on the proportion of patients with Alzheimer’s disease, Parkinson’s disease, epilepsy and multiple sclerosis, the authors wrote. Additionally, the researchers investigated the impact of biologic therapies compared with conventional therapies in these patients.

Infographic showing odds of neuro conditions in patients w/ ankylosing spondylitis
“In this study, for the first time, we have demonstrated an association between AS and neurological diseases including AD, epilepsy, and PD but not MS,” Abdulla Watad, MD, and colleagues wrote in Atad A, et al. Pharmacological Research. 2022;doi:10.1016/j.phrs.2022.106325.

 

Patients were matched on a 1:5 case-to-control ratio. Endpoints included the prevalence of Alzheimer’s disease, Parkinson’s disease and multiple sclerosis. The authors also analyzed the impact of biologics, including TNF inhibitors, on the prevalence of these diseases.

In all, 4,082 patients with AS and 20,397 age- and gender-matched control individuals were included in the analysis. AS was associated with higher rates of Alzheimer’s disease (OR = 1.46; 95% CI, 1.13-1.87), epilepsy (OR = 2.33; 95% CI, 1.75-3.09) and Parkinson’s disease (OR = 2.75; 95% CI, 2.04-3.72). There was no statistically significant connection between AS and multiple sclerosis, the authors wrote. Additionally, patients with AS who used TNF inhibitors demonstrated a reduced chance of developing Alzheimer’s disease (OR = 0.1; 95% CI, 0.01-0.74).
In this study, for the first time, we have demonstrated an association between AS and neurological diseases including [Alzheimer’s disease (AD)], epilepsy and [Parkinson’s disease (PD)] but not [multiple sclerosis (MS)],” Watad and colleagues wrote. “Furthermore, we found that AS patients treated with TNFi, but not cDMARDs had lower rates of AD.”

Reference:

Mercieca C, et al. Curr. Rheuma Rep. 2014.