Some Sjögren’s patients are at higher risk for Parkinson’s, this study finds. This study determined the incidence and risk of Parkinson disease (PD) in patients with Sjögren syndrome(SS) .
Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study.
doi: 10.1097/MD.0000000000014984
Research Article: Observational Study
Parkinson’s disease is a brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination. It occurs when nerve cells, or neurons, in an area of the brain that controls movement become impaired and/or die.
In total, 12,640 patients in the SS cohort and 50,560 in the non-SS cohort were enrolled from Taiwan's National Health Insurance Research Database from 2000 to 2010. We used the Cox multi-variable proportional hazards model to determine the risk factors for PD in the SS cohort.
We observed an increased incidence of PD in patients with SS, with a crude hazard ratio (HR) of 1.40 and an adjusted HR (aHR) of 1.23. The cumulative incidence of PD was 1.95% higher in the SS cohort than in the non-SS cohort. The SS cohort had an elevated HR under medication use, namely cevimeline and pilocarpine (crude HR, 1.28), hydroxychloroquine (crude HR, 1.43; aHR, 1.46), and methylprednisolone (crude HR, 2.21; aHR, 1.49). Patients receiving other non-hydroxychloroquine immunosuppressant therapies had a lower risk (aHR, 0.86) of PD. Furthermore, patients with SS aged 20 to 49 years had a 1.93-fold higher risk of PD than did those without SS (aHR, 1.93). The risk of PD was higher (aHR, 2.20) in patients with SS without comorbidities than in those with comorbidities. The aHR of PD significantly increased when the follow-up period exceeded 9 years (aHR, 1.93).
We determined an increased risk of PD in patients with SS.
In conclusion, our study was the 1st to determine an increased risk of PD in patients with SS and that non-hydroxychloroquine immunosuppressant therapy may reduce this risk. Further research is warranted to determine the possible underlying mechanisms and the potential role of non-hydroxychloroquine immunosuppressants in ameliorating PD.
Further investigation is warranted to determine the possible underlying mechanisms and the potential role of non-hydroxychloroquine immunosuppressants in ameliorating PD.
QUICK FACTS ABOUT THIS STUDY:
- patients with Sjögren’s were 23% more likely to develop Parkinson’s.
- the risk of Parkinson's was only seen in women.
- Parkinson’s disease was more likely in younger patients with Sjögren’s syndrome.
- Certain medications elevated the risk of Parkinson’s disease including Evoxac (cevimeline), pilocarpine, hydroxychloroquine (Plaquenil), and methylprednisolone.
- Patients taking non-hydroxychloroquine immunosuppressant therapies had an almost 15% lower risk of developing Parkinson’s disease
- Risk of Parkinson’s was increased 2.2 times in Sjögren’s patients without comorbidities (additional chronic diseases), compared to those with comorbidities
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