“Taking a biological or targeted synthetic DMARD reduced the risk of dementia by 17% compared to patients who received only a conventional synthetic DMARD,” said lead study author Sebastian Sattui, MD, MS, a rheumatologist at the Hospital for Specialized Surgery (HSS ) in New York City. The study was carried out in collaboration with researchers from Weill Cornell Medicine and the University of Alabama in Birmingham.
Dr. Sattui said that treatment for rheumatoid arthritis patients has become more complex based on an understanding that rheumatoid arthritis has an impact far beyond what is considered classic manifestations. Previous studies have shown that inflammatory diseases like rheumatoid arthritis can increase your risk of dementia and that TNF agents can play a role in preventing dementia from occurring.
In the new study, researchers identified a cohort of rheumatoid arthritis patients in Medicare data from 2006 to 2017. To be eligible, patients had to be continuously enrolled in Medicare Parts A, B, and D for at least 12 months, and 40 years of age have no prior diagnosis of dementia.
In the sample of 141,326 eligible rheumatoid arthritis patients, the crude dementia rate was 2.0 per 100 person-years for patients with conventional synthetic DMARDs and 1.3 for those with biological DMARDs. After adjusting for factors such as age, gender, and other comorbidities, patients with biological or targeted synthetic DMARDs had a 17% lower risk of dementia than patients with conventional synthetic DMARDs. No significant differences were observed between the different classes of biological or targeted synthetic DMARDs, suggesting that the decreased risk may be explained by the general decrease in inflammation rather than a specific mechanism of action.
The researchers say clinicians should use this new information in treatment decisions, but prospective studies are needed. “Our work shows another dimension in which rheumatoid arthritis treatment can affect the overall health and quality of life of our patients,” said Dr. Sattui. “Rheumatoid arthritis is a systemic disease and can have cognitive effects. However, these complications seem to have pathways similar to joint disease, and the drugs we use to treat rheumatoid arthritis could be effective in preventing dementia in patients with rheumatoid arthritis. Future studies need to assess the effects of interventions such as B. The strategy for treating the goal to evaluate the incidence of dementia in patients with rheumatoid arthritis. ”
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About HSS
HSS is the world’s leading academic medical center for musculoskeletal health. The focus is on the Hospital for Special Surgery, which is number one in orthopedics nationwide for the eleventh year in a row, number four in rheumatology by US News & World Report (2020-2021) and has been named the market leader in pediatric orthopedics by the USA News & World Report List of Best Children’s Hospitals (2020-2021). Founded in 1863, the hospital has the lowest orthopedic complication and readmission rates in the country and one of the lowest infection rates. HSS was the first New York State company to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four times in a row. The worldwide standard knee endoprosthesis was developed at HSS in 1969. HSS is a subsidiary of Weill Cornell Medical College and has a main campus in New York City and facilities in New Jersey, Connecticut, and in the Long Island and Westchester Counties of New York State and Florida. In addition to patient care, HSS is a leader in research, innovation and education. The HSS Research Institute consists of 20 laboratories and 300 employees who focus on promoting the health of the musculoskeletal system through the prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was founded in 2016 to unlock the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for doctors, nurses, healthcare professionals, academic trainees, and consumers in more than 130 countries. Through HSS Global Ventures, the facility works with medical centers and other organizations to improve the quality and value of musculoskeletal care and make world-class HSS care more accessible nationally and internationally.
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