Takeaway
- A nationwide, population-based retrospective cohort finds that for patients with rheumatoid arthritis (RA), using disease-modifying antirheumatic drugs (DMARDs) may reduce the risk for dementia, and the effect appears to be dose-dependent.
Why this matters
- Findings justify a randomized controlled trial.
- The mechanism for the effect may be by reducing inflammation.
Study design
- A nationwide, population-based retrospective cohort using Taiwan's National Health Insurance Research Database.
- Patients who were newly diagnosed with RA between 2000 and 2005 (n=20,707) were evaluated for all-cause dementia and were compared with a control group without RA (n=62,121).
- DMARDs included methotrexate, azathioprine, and biological DMARDs.
- Funding: Kaohsiung Municipal Ta-Tung Hospital, Taiwan; other.
Key results
- The RA cohort was 37% less likely to develop dementia vs the non-RA cohort (aHR, 0.63; P<.001).
- The RA cohort using DMARDs was 52% less likely to develop dementia (aHR, 0.48; P<.001).
- The RA cohort not using DMARDs was 18% less likely to develop dementia (aHR, 0.82; P=.031).
- The effect was dose-dependent, using cumulative defined daily doses of DMARDs and RA without DMARD use (n=6118) as the reference group:
- Low dose: aHR, 0.68; P=.021.
- Medium dose: aHR, 0.63; P=.012.
- High dose: aHR, 0.20; P<.001.
Limitation
- No specification of elapsed time between onset of RA and onset of dementia.
References
References
