Session Type: Abstract Submissions (ACR)
Alzheimer’s disease (AD) dementia is the most common form of dementia affecting > 25 million people worldwide without known cure. Research regarding involvement of inflammatory component of Alzheimer’s Disease (AD) has been well documented. A recent study via whole genome and exome DNA sequencing have provided evidence that coding mutations in the TREM2 gene are associated with a ~2.5-4 fold increased risk in developing AD. Notably TREM2 is only expressed within macrophages and dendritic cells in the periphery and within microglia within the brain and is involved in innate immunity, suggesting that alterations in neuroinflammation are directly linked to the development and progression of AD. Autoimmune diseases such as rheumatoid arthritis (RA) known to be a chronic systemic inflammatory disorder may thereby be important to see if the prevalence of these diseases makes a subsequent neurodegenerative diagnosis like AD more likely.
Our objective was to investigate whether the risk of Alzheimer’s disease is increased in patient with rheumatoid arthritis in a large population cohort.
Our study consists of a large retrospective hospital based cohort from a network of north east Ohio health providers through Explorys database. Population was defined by a) subjects using medications used in RA and AD, b) ICD9 codes (714.0, 294.1, 331.0, 331.11, 331.19, 331.82, 331.83, 290.0, 290.43, 294.20 and 294.21) was used to understand the specific subtypes of dementia. Descriptive analysis was performed on individual cohorts. Statistical Analysis: Relative risk of use of AD medications among subjects using RA medications will be compared with a control cohort without these medications use, to determine the risk of AD medication use in each cohort.
Overall number of subjects from our database was 2,592,280 (77% females). Number of subjects with RA medication + AD medications was 430. Subjects with either RA and/or FDA approved AD medications were 52,330. Subjects with RA but no AD medications was 37,650. In this cohort, 60% of treated RA subjects had an RA diagnosis based on ICD9 codes , but only 2.2 % subjects using AD medications had an AD or AD dementia diagnosis and 1.25% had a diagnosis of mild cogntive impairment based on ICD9 codes.
Relative risk of AD medication use among subjects using RA medications was 2.02 [1.83-2.22], P<0.001. This effect was noted to be most prominent in subjects less than 65 years old.
Our study supports that patients with RA could be associated with an increased risk of Alzheimer’s Dementia and raises the possibility of shared risk factors that may not have been appreciated previously. Further study into this association would help develop guidelines to screen for cognitive impairment and elucidate novel therapeutic options in AD.
M. E. Husni,
national psoriasis foundation,
Bristol Myers Squibb,
Novartis Pharmaceutical Corporation,
Arthritis National Research Foundation,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/systemic-inflammation-in-alzheimers-disease-relevance-to-patients-with-rheumatoid-arthritis/