Patients with rheumatoid arthritis have a 1.74-fold increased risk for Parkinson's disease
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Key takeaways:
- Patients with seropositive rheumatoid arthritis were at a higher risk to develop Parkinson’s, researchers said.
- The researchers concluded that physicians who care for patients with RA should be aware of this elevated risk.
Patients with rheumatoid arthritis demonstrate a nearly 1.5-fold increased risk for developing Parkinson’s disease vs. those without RA, according to data published in JAMA Neurology.
“The pathogenesis of Parkinson disease (PD) has been largely elusive, except for a small fraction of cases caused by rare genetic variants,” Jihun Kang, MD, PhD, of the Kosin University College of Medicine, in Busan, South Korea, and colleagues wrote. “Multiple lines of clinical and experimental evidence have suggested that autoimmunity is involved in the activation of microglia and monocytes that play a central role in the initiation and amplification of brain inflammation.”
To investigate a possible connection between RA and Parkinson’s disease, Kang and colleagues analyzed data from the Korean National Health Insurance Service on patients who were diagnosed with RA between 2010 and 2017. Patients were identified via diagnostic code and prescriptions for any disease-modifying antirheumatic drug.
Individuals who were younger than 40 years, registered in the Rare and Intractable Disease (RID) program, demonstrated a disease that was not rheumatic in nature, had a history of Parkinson’s disease, were diagnosed with Parkinson’s disease within 1 year of enrollment, had missing data or could not be matched in the control group were excluded.
The primary outcome was the diagnosis of Parkinson’s disease. For certification, patients were required to have received an official diagnosis from a neurologist. Patients were followed from 1 year following the diagnosis of RA until either receiving a diagnosis of Parkinson’s disease or the end of the study on Dec. 31, 2019.
The analysis included a total of 328,080 patients, of whom 1,093 were diagnosed with Parkinson’s disease. According to the researchers, patients with RA demonstrated a 1.74-fold increased risk of developing Parkinson’s disease, compared with patients in the control group (95% CI, 1.52-1.99). In addition, patients with seropositive RA were more likely to develop Parkinson’s disease (adjusted HR = 1.95; 95% CI, 1.68-2.26). Conversely, patients with seronegative RA were not more 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 and that [seropositive RA] conferred an augmented risk of PD,” Kang and colleagues wrote. “... The study findings suggest that physicians who care for patients with RA should be aware of the elevated risk of PD and prompt referral to a neurologist should be considered at onset of early motor symptoms of PD in patients with RA without synovitis.”
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