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Ankylosing Spondylitis: A Risk Factor for Parkinsonism-A Nationwide Population-Based Study

Authors
 Seo Yeon Yoon  ;  Seok-Jae Heo  ;  Yong Wook Kim  ;  Seung Nam Yang  ;  Hyun Im Moon 
Citation
 JOURNAL OF PARKINSONS DISEASE, Vol.12(1) : 353-360, 2022-01 
Journal Title
JOURNAL OF PARKINSONS DISEASE
ISSN
 1877-7171 
Issue Date
2022-01
MeSH
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use ; Cohort Studies ; Humans ; Incidence ; Parkinson Disease* / drug therapy ; Parkinson Disease* / epidemiology ; Parkinson Disease* / etiology ; Parkinsonian Disorders* / chemically induced ; Parkinsonian Disorders* / etiology ; Retrospective Studies ; Risk Factors ; Spondylitis, Ankylosing* / chemically induced ; Spondylitis, Ankylosing* / drug therapy ; Spondylitis, Ankylosing* / epidemiology
Keywords
Ankylosing spondylitis ; National Health Insurance ; Parkinson’s disease ; population-based cohort
Abstract
Background: Ankylosing spondylitis (AS) is an immune-mediated, chronic inflammatory rheumatic disorder. The etiology of Parkinson's disease (PD) is multifactorial; however, inflammation is receiving an increasing amount of attention as an underlying cause of the neurodegenerative process of PD.

Objective: We performed a nationwide longitudinal, population-based matched cohort study to assess the association with the later development of parkinsonism in Korea.

Methods: This study was conducted using records from the Health Insurance Review and Assessment Service database. The cumulative incidence rate of PD was estimated. Fine-Gray subdistribution hazard models were used to identify hazards associated with PD development based on the presence of AS. Exposure to anti-inflammatory drugs was measured and analyzed to determine the protective effect of these medications. Additionally, the hazard ratio (HR) for atypical parkinsonism was estimated.

Results: The results of the Fine-Gray subdistribution hazard model revealed that the HR for PD development in the AS group was 1.82 (95%confidence interval [CI], 1.38-2.39, p < 0.001). A significant decrease in PD development was observed in patients with AS taking non-steroidal anti-inflammatory drugs (NSAIDs). The HR for atypical parkinsonism in the AS group was 3.86 (95%CI, 1.08-13.78, p < 0.05).

Conclusion: We found that AS was associated with an increased risk of PD and atypical parkinsonism. NSAIDs used for AS control have some protective effects against PD. Further studies assessing whether biological treatment mitigates PD risk in patients with high activity are warranted.
Full Text
https://content.iospress.com/articles/journal-of-parkinsons-disease/jpd212878
DOI
10.3233/JPD-212878
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Wook(김용욱) ORCID logo https://orcid.org/0000-0002-5234-2454
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188421
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