Some glucose-lowering drugs may protect against Parkinson’s disease

  • Brauer R & al.
  • Brain
  • 4 Oct 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Use of dipeptidyl peptidase-4 inhibitors (DPP4is) and/or glucagon-like peptide-1 receptor agonists (GLP-1RAs) in type 2 diabetes (T2D) is associated with a lower Parkinson’s disease (PD) rate compared with other oral glucose-lowering drugs.

Why this matters

  • PD risk appears to be elevated in people with T2D.

Study design

  • Population-based study using historic primary care data, including 21,175 using glitazones; 36,897 using DPP4is; 10,684 using GLP-1RAs; and 38,393 using other oral glucose-lowering drugs.
  • Followed for ~3 years.
  • Funding: The Cure Parkinson’s Trust.

Key results

  • PD developed in 329 (0.3%) of 100,288 total patients, and in 0.5% glitazone users, 0.2% DPP4i users, 0.2% GLP-1RA users, and 0.4% users of other agents.
  • Compared with users of other oral glucose-lowering drugs, incident rate ratios (IRRs; 95% CIs) for PD incidence were:
    • Glitazones: 0.83 (0.64-1.07).
    • DPP4is: 0.54 (0.41-0.73).
    • GLP-1RAs: 0.40 (0.24-0.66).
  • In adjusted analysis:
    • There was no evidence of an association between glitazone use and PD (IRR, 1.17; 95% CI, 0.76-1.63; P=.467).
    • There was strong evidence of an inverse association between PD onset and use of DPP4is (IRR, 0.64; 95% CI, 0.43-0.88) and GLP-1RAs (IRR, 0.38; 95% CI, 0.17-0.60).

Limitations

  • Possible misclassification, nonadherence.
  • Retrospective data, treatment recommendations await ongoing phase 3 trial results.