T2D: thiazolidinediones are linked to protection against Parkinson disease

  • Hussain S & al.
  • Neurol Sci
  • 9 Jun 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Results of a meta-analysis based on real-world evidence suggest a protective effect of thiazolidinediones (TZDs) against Parkinson disease (PD), particularly in people with type 2 diabetes (T2D).

Why this matters

  • Currently, no disease-modifying treatment prevents PD or slows its progression.
  • TZDs suppress neuroinflammatory processes in microglia and astrocytes, but evidence of a neuroprotective effect in humans has been inconsistent.

Study design

  • Meta-analysis of 4 retrospective cohort studies with 312,924 participants with T2D, including 66,129 TZD users.
  • Also used data for nonusers of TZDs from another retrospective study, pooled for the secondary outcome of PD risk among TZD users with T2D vs a general population of nonusers.
  • Funding: None disclosed.

Key results

  • Pooled adjusted (a)HR for PD among people with T2D who used vs did not use TZDs was 0.81 (P=.004).
  • The protective effect was significant for a subgroup with >5 years of follow-up (aHR, 0.74; P=.0008) but not with ≤5 years (aHR, 0.95; P=.68).
  • The effect was significant for white populations (aHR, 0.78; P=.003) but not among people of Asian ancestry (aHR, 0.90; P=.45).
  • The protective effect was also significant for TZD users vs nonusers, including people without T2D (aHR, 0.72; P=.04).

Limitations

  • Included only English-language articles.
  • All included studies were retrospective.