Tsai Kao-Sung, Lu Ming-Kuei, Liu Chao-Hong, Tsai Fuu-Jen, Chen Wen-Chi, Chen Huey-Yi, Lin Heng-Jun, Lin Cheng-Li, Lee Jen-Chih, Man Kee-Ming, Ho Chien-Yi, Chen Yung-Hsiang
School of Chinese Medicine, Graduate Institute of Integrated Medicine, College of Chinese Medicine, Ph.D. Program for Translational Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan.
Million-Person Precision Medicine Initiative, Departments of Dermatology, Neurology, Medical Genetics, Obstetrics and Gynecology, Urology, and Medical Research, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan.
Pharmaceuticals (Basel). 2024 Oct 8;17(10):1342. doi: 10.3390/ph17101342.
Scabies is typically treated with scabicides like lindane, which poses a risk for acute neural toxicity. Lindane's prolonged use, particularly in agriculture, is linked to neurodegenerative diseases, including Parkinson's disease (PD), the second most common neurodegenerative disorder. This study aimed to evaluate whether scabies patients, particularly those treated with topical lindane, are at increased risk of developing PD.
A nationwide population-based cohort study was conducted using data from Taiwan's National Health Research Institutes claims database from 2000 to 2018. The study included 27,173 patients with scabies, matched to a control group, with both groups followed for up to 18 years. The primary outcome was the incidence of newly diagnosed PD, and the hazard ratio (HR) for PD was calculated, focusing on those treated with topical lindane.
Among the 54,346 patients, 1639 (3.0%) were newly diagnosed with PD, with 993 (60.6%) from the scabies group and 646 (39.4%) from the control group. Scabies patients had an adjusted hazard ratio (aHR) of 1.46 (95% CI 1.32-1.63) for developing PD compared to controls. However, patients treated with topical lindane had a significantly lower aHR for PD at 0.15 (95% CI 0.12-0.19; < 0.001), with a lower cumulative incidence of PD also observed in this group ( < 0.001).
Scabies patients are at a 1.46-fold increased risk of developing PD, but those treated with lindane exhibit a significantly lower risk, suggesting potential protective effects of lindane against PD.
疥疮通常用林丹等杀疥剂治疗,林丹存在急性神经毒性风险。林丹的长期使用,尤其是在农业领域,与神经退行性疾病有关,包括第二常见的神经退行性疾病帕金森病(PD)。本研究旨在评估疥疮患者,尤其是接受外用林丹治疗的患者,患帕金森病的风险是否增加。
利用台湾国家卫生研究院2000年至2018年索赔数据库的数据进行了一项全国性的基于人群的队列研究。该研究纳入了27173名疥疮患者,并与一个对照组进行匹配,两组均随访长达18年。主要结局是新诊断帕金森病的发病率,并计算帕金森病的风险比(HR),重点关注接受外用林丹治疗的患者。
在54346名患者中,1639人(3.0%)新诊断为帕金森病,其中993人(60.6%)来自疥疮组,646人(39.4%)来自对照组。与对照组相比,疥疮患者患帕金森病的调整后风险比(aHR)为1.46(95%CI 1.32 - 1.63)。然而,接受外用林丹治疗的患者患帕金森病的aHR显著较低,为0.15(95%CI 0.12 - 0.19;<0.001),该组帕金森病的累积发病率也较低(<0.001)。
疥疮患者患帕金森病的风险增加1.46倍,但接受林丹治疗的患者风险显著较低,表明林丹对帕金森病可能具有保护作用。