Nathanael R. Fillmore
Publications / 2022
paper
Alzheimer's & Dementia2022doi:10.1002/alz.12465

Potential long-term effect of tumor necrosis factor inhibitors on dementia risk: A propensity score matched retrospective cohort study in US veterans.

Chunlei Zheng†, Nathanael R. Fillmore†, Jaime Ramos-Cejudo, Mary Brophy, Ricardo Osorio, Mark E. Gurney, Wei Qiao Qiu, Rhoda Au, George Perry, Maureen Dubreuil, Shu G. Chen, Xin Qi, Pamela B. Davis, Nhan Do, Rong Xu

† Equal first authorship

Summary

Patients with rheumatoid arthritis who used tumor necrosis factor inhibitors had a significantly lower risk of developing dementia and Alzheimer's disease over a 20 year period. These findings suggest that this class of medication may provide long term neuroprotective benefits in addition to treating joint inflammation.

Key result

Tumor necrosis factor inhibitor use was associated with a reduced risk of dementia (hazard ratio: 0.64; 95% confidence interval: 0.52-0.80) and Alzheimer disease (hazard ratio: 0.57; 95% confidence interval: 0.39-0.83) among patients with rheumatoid arthritis.

Abstract

INTRODUCTION: Tumor necrosis factor (TNF) inhibitors are widely used to treat rheumatoid arthritis (RA) and their potential to retard Alzheimer's disease (AD) progression has been reported. However, their long-term effects on the dementia/AD risk remain unknown. METHODS: A propensity scored matched retrospective cohort study was conducted among 40,207 patients with RA within the US Veterans Affairs health-care system from 2000 to 2020. RESULTS: A total of 2510 patients with RA prescribed TNF inhibitors were 1:2 matched to control patients. TNF inhibitor use was associated with reduced dementia risk (hazard ratio [HR]: 0.64, 95% confidence interval [CI]: 0.52-0.80), which was consistent as the study period increased from 5 to 20 years after RA diagnosis. TNF inhibitor use also showed a long-term effect in reducing the risk of AD (HR: 0.57, 95% CI: 0.39-0.83) during the 20 years of follow-up. CONCLUSION: TNF inhibitor use is associated with lower long-term risk of dementia/AD among US veterans with RA.

Key figure

Key figure from Potential long-term effect of tumor necrosis factor inhibitors on dementia risk: A propensity score matched retrospective cohort study in US veterans.