Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA.
Department of Clinical Sciences Lund, Rheumatology, Lund University, Lund, Sweden.
J Parkinsons Dis. 2021;11(2):821-832. doi: 10.3233/JPD-202418.
Rheumatoid arthritis (RA) and the genetic risk landscape of autoimmune disorders and Parkinson's disease (PD) overlap. Additionally, anti-inflammatory medications used to treat RA might influence PD risk.
To use a population-based approach to determine if there is an association between pre-occurring rheumatoid arthritis (RA) and later-life risk of PD.
The study population was 3.6 million residents of Sweden, who were alive during part or all of the follow-up period; 1997-2016. We obtained diagnoses from the national patient registry and identified 30,032 PD patients, 8,256 of whom each was matched to ten controls based on birth year, sex, birth location, and time of follow-up. We determined the risk reduction for PD in individuals previously diagnosed with RA. We also determined if the time (in relation to the index year) of the RA diagnosis influenced PD risk and repeated the analysis in a sex-stratified setting.
Individuals with a previous diagnosis of RA had a decreased risk of later developing PD by 30-50% compared to individuals without an RA diagnosis. This relationship was strongest in our conservative analysis, where the first PD diagnosis occurred close to the earliest PD symptoms (odds ratio 0.47 (CI 95% 0.28-0.75, p = 0.0006); with the greatest risk reduction in females (odds ratio 0.40 (CI 95% 0,19-0.76, p = 0.002).
Our findings provide evidence that individuals diagnosed with RA have a significantly lower risk of developing PD than the general population. Our data should be considered when developing or repurposing therapies aimed at modifying the course of PD.
类风湿关节炎（RA）与自身免疫性疾病和帕金森病（PD）的遗传风险图谱重叠。此外，用于治疗 RA 的抗炎药物可能会影响 PD 的风险。
采用基于人群的方法来确定预先存在的类风湿关节炎（RA）与晚年 PD 发病风险之间是否存在关联。
研究人群为瑞典 360 万居民，他们在随访期间的部分或全部时间内仍存活；1997-2016 年。我们从国家患者登记处获得了诊断，并确定了 30032 名 PD 患者，其中 8256 名患者根据出生年份、性别、出生地点和随访时间与 10 名对照者进行了匹配。我们确定了先前被诊断为 RA 的个体患 PD 的风险降低。我们还确定了 RA 诊断的时间（与索引年的关系）是否影响 PD 风险，并在性别分层的环境中重复了该分析。
与没有 RA 诊断的个体相比，先前诊断为 RA 的个体随后发展为 PD 的风险降低了 30-50%。这种关系在我们的保守分析中最强，其中 PD 的首次诊断发生在最早的 PD 症状附近（优势比 0.47（95%CI 0.28-0.75，p=0.0006）；女性的风险降低最大（优势比 0.40（95%CI 0.19-0.76，p=0.002）。
我们的研究结果提供了证据，表明被诊断为 RA 的个体患 PD 的风险明显低于一般人群。在制定或重新制定旨在改变 PD 病程的治疗方法时，应考虑我们的数据。
