Protective effect of antirheumatic drugs on dementia in rheumatoid arthritis patients

Andy Judge; Cesar Garriga; Nigel K Arden; Simon Lovestone; Dani Prieto-Alhambra; Cyrus Cooper; Christopher J Edwards

doi:10.1016/j.trci.2017.10.002

Protective effect of antirheumatic drugs on dementia in rheumatoid arthritis patients

Andy Judge
, Cesar Garriga
, Nigel K Arden
, Simon Lovestone
, Dani Prieto-Alhambra
, Cyrus Cooper
, Christopher J Edwards

Bristol Medical School (THS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

72 Citations (Scopus)

253 Downloads (Pure)

Abstract

Introduction: Rheumatoid arthritis is a systemic inflammatory disease, and classical disease-modifying antirheumatic drugs (cDMARDs) have proven efficacy. It is unknown what impact cDMARDs might have on dementia as an outcome.

Methods: Incident diagnoses of rheumatoid arthritis in persons over 18 years from 1995 to 2011 were identified from the UK Clinical Practice Research Datalink. There were 3876 cDMARD users and were propensity score matched to 1938 nonusers, on a wide range of confounders. Impact on dementia was assessed using survival models.

Results: cDMARD users were at reduced risk of dementia (hazard ratio: 0.60; 95% confidence interval: 0.42-0.85). The effect was strongest in methotrexate users (hazard ratio: 0.52; 95% confidence interval; 0.34-0.82).

Discussion: The strong effect of cDMARD use on halving of dementia risk requires replication in a trial and may provide an important therapeutic pharmacological treatment.

Original language	English
Pages (from-to)	612-621
Number of pages	10
Journal	Alzheimer's and Dementia: Translational Research and Clinical Interventions
Volume	3
Issue number	4
Early online date	9 Nov 2017
DOIs	https://doi.org/10.1016/j.trci.2017.10.002
Publication status	Published - Nov 2017

Keywords

Alzheimer's disease
Clinical Practice Research Datalink
Dementia
Disease-modifying antirheumatic drugs (DMARDs)
Epidemiology
Fine and gray models
Methotrexate
Propensity score matching
Rheumatoid arthritis

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@article{c098c8a725874b499d45be53a9544b7b,

title = "Protective effect of antirheumatic drugs on dementia in rheumatoid arthritis patients",

abstract = "Introduction: Rheumatoid arthritis is a systemic inflammatory disease, and classical disease-modifying antirheumatic drugs (cDMARDs) have proven efficacy. It is unknown what impact cDMARDs might have on dementia as an outcome.Methods: Incident diagnoses of rheumatoid arthritis in persons over 18 years from 1995 to 2011 were identified from the UK Clinical Practice Research Datalink. There were 3876 cDMARD users and were propensity score matched to 1938 nonusers, on a wide range of confounders. Impact on dementia was assessed using survival models.Results: cDMARD users were at reduced risk of dementia (hazard ratio: 0.60; 95\% confidence interval: 0.42-0.85). The effect was strongest in methotrexate users (hazard ratio: 0.52; 95\% confidence interval; 0.34-0.82).Discussion: The strong effect of cDMARD use on halving of dementia risk requires replication in a trial and may provide an important therapeutic pharmacological treatment.",

keywords = "Alzheimer's disease, Clinical Practice Research Datalink, Dementia, Disease-modifying antirheumatic drugs (DMARDs), Epidemiology, Fine and gray models, Methotrexate, Propensity score matching, Rheumatoid arthritis",

author = "Andy Judge and Cesar Garriga and Arden, \{Nigel K\} and Simon Lovestone and Dani Prieto-Alhambra and Cyrus Cooper and Edwards, \{Christopher J\}",

year = "2017",

month = nov,

doi = "10.1016/j.trci.2017.10.002",

language = "English",

volume = "3",

pages = "612--621",

journal = "Alzheimer's and Dementia: Translational Research and Clinical Interventions",

issn = "2352-8737",

publisher = "John Wiley and Sons Inc",

number = "4",

}

TY - JOUR

T1 - Protective effect of antirheumatic drugs on dementia in rheumatoid arthritis patients

AU - Judge, Andy

AU - Garriga, Cesar

AU - Arden, Nigel K

AU - Lovestone, Simon

AU - Prieto-Alhambra, Dani

AU - Cooper, Cyrus

AU - Edwards, Christopher J

PY - 2017/11

Y1 - 2017/11

N2 - Introduction: Rheumatoid arthritis is a systemic inflammatory disease, and classical disease-modifying antirheumatic drugs (cDMARDs) have proven efficacy. It is unknown what impact cDMARDs might have on dementia as an outcome.Methods: Incident diagnoses of rheumatoid arthritis in persons over 18 years from 1995 to 2011 were identified from the UK Clinical Practice Research Datalink. There were 3876 cDMARD users and were propensity score matched to 1938 nonusers, on a wide range of confounders. Impact on dementia was assessed using survival models.Results: cDMARD users were at reduced risk of dementia (hazard ratio: 0.60; 95% confidence interval: 0.42-0.85). The effect was strongest in methotrexate users (hazard ratio: 0.52; 95% confidence interval; 0.34-0.82).Discussion: The strong effect of cDMARD use on halving of dementia risk requires replication in a trial and may provide an important therapeutic pharmacological treatment.

AB - Introduction: Rheumatoid arthritis is a systemic inflammatory disease, and classical disease-modifying antirheumatic drugs (cDMARDs) have proven efficacy. It is unknown what impact cDMARDs might have on dementia as an outcome.Methods: Incident diagnoses of rheumatoid arthritis in persons over 18 years from 1995 to 2011 were identified from the UK Clinical Practice Research Datalink. There were 3876 cDMARD users and were propensity score matched to 1938 nonusers, on a wide range of confounders. Impact on dementia was assessed using survival models.Results: cDMARD users were at reduced risk of dementia (hazard ratio: 0.60; 95% confidence interval: 0.42-0.85). The effect was strongest in methotrexate users (hazard ratio: 0.52; 95% confidence interval; 0.34-0.82).Discussion: The strong effect of cDMARD use on halving of dementia risk requires replication in a trial and may provide an important therapeutic pharmacological treatment.

KW - Alzheimer's disease

KW - Clinical Practice Research Datalink

KW - Dementia

KW - Disease-modifying antirheumatic drugs (DMARDs)

KW - Epidemiology

KW - Fine and gray models

KW - Methotrexate

KW - Propensity score matching

KW - Rheumatoid arthritis

U2 - 10.1016/j.trci.2017.10.002

DO - 10.1016/j.trci.2017.10.002

M3 - Article (Academic Journal)

C2 - 29201995

SN - 2352-8737

VL - 3

SP - 612

EP - 621

JO - Alzheimer's and Dementia: Translational Research and Clinical Interventions

JF - Alzheimer's and Dementia: Translational Research and Clinical Interventions

IS - 4

ER -

Protective effect of antirheumatic drugs on dementia in rheumatoid arthritis patients

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