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Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study
To determine the incidence and risk of Parkinson disease (PD) in patients with Sjögren syndrome (SS) according to a nationwide population-based database. In total, 12,640 patients in the SS cohort and 50,560 in the non-SS cohort were enrolled from Taiwan's National Health Insurance Research Dat...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455855/ https://www.ncbi.nlm.nih.gov/pubmed/30946325 http://dx.doi.org/10.1097/MD.0000000000014984 |
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author | Ju, Uei-Han Liu, Feng-Cheng Lin, Chin-Sheng Huang, Wen-Yen Lin, Te-Yu Shen, Chih-Hao Chou, Yu-Ching Lin, Cheng-Li Lin, Kuen-Tze Kao, Chia-Hung Chen, Chao-Hsien Yang, Tse-Yen |
author_facet | Ju, Uei-Han Liu, Feng-Cheng Lin, Chin-Sheng Huang, Wen-Yen Lin, Te-Yu Shen, Chih-Hao Chou, Yu-Ching Lin, Cheng-Li Lin, Kuen-Tze Kao, Chia-Hung Chen, Chao-Hsien Yang, Tse-Yen |
author_sort | Ju, Uei-Han |
collection | PubMed |
description | To determine the incidence and risk of Parkinson disease (PD) in patients with Sjögren syndrome (SS) according to a nationwide population-based database. In total, 12,640 patients in the SS cohort and 50,560 in the non-SS cohort were enrolled from Taiwan's National Health Insurance Research Database from 2000 to 2010. We used the Cox multivariable proportional hazards model to determine the risk factors for PD in the SS cohort. We observed an increased incidence of PD in patients with SS, with a crude hazard ratio (HR) of 1.40 and an adjusted HR (aHR) of 1.23. The cumulative incidence of PD was 1.95% higher in the SS cohort than in the non-SS cohort. The SS cohort had an elevated HR under medication use, namely cevimeline and pilocarpine (crude HR, 1.28), hydroxychloroquine (crude HR, 1.43; aHR, 1.46), and methylprednisolone (crude HR, 2.21; aHR, 1.49). Patients receiving other non-hydroxychloroquine immunosuppressant therapies had a lower risk (aHR, 0.86) of PD. Furthermore, patients with SS aged 20 to 49 years had a 1.93-fold higher risk of PD than did those without SS (aHR, 1.93). The risk of PD was higher (aHR, 2.20) in patients with SS without comorbidities than in those with comorbidities. The aHR of PD significantly increased when the follow-up period exceeded 9 years (aHR, 1.93). We determined an increased risk of PD in patients with SS. Further investigation is warranted to determine the possible underlying mechanisms and the potential role of non-hydroxychloroquine immunosuppressants in ameliorating PD. |
format | Online Article Text |
id | pubmed-6455855 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-64558552019-05-29 Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study Ju, Uei-Han Liu, Feng-Cheng Lin, Chin-Sheng Huang, Wen-Yen Lin, Te-Yu Shen, Chih-Hao Chou, Yu-Ching Lin, Cheng-Li Lin, Kuen-Tze Kao, Chia-Hung Chen, Chao-Hsien Yang, Tse-Yen Medicine (Baltimore) Research Article To determine the incidence and risk of Parkinson disease (PD) in patients with Sjögren syndrome (SS) according to a nationwide population-based database. In total, 12,640 patients in the SS cohort and 50,560 in the non-SS cohort were enrolled from Taiwan's National Health Insurance Research Database from 2000 to 2010. We used the Cox multivariable proportional hazards model to determine the risk factors for PD in the SS cohort. We observed an increased incidence of PD in patients with SS, with a crude hazard ratio (HR) of 1.40 and an adjusted HR (aHR) of 1.23. The cumulative incidence of PD was 1.95% higher in the SS cohort than in the non-SS cohort. The SS cohort had an elevated HR under medication use, namely cevimeline and pilocarpine (crude HR, 1.28), hydroxychloroquine (crude HR, 1.43; aHR, 1.46), and methylprednisolone (crude HR, 2.21; aHR, 1.49). Patients receiving other non-hydroxychloroquine immunosuppressant therapies had a lower risk (aHR, 0.86) of PD. Furthermore, patients with SS aged 20 to 49 years had a 1.93-fold higher risk of PD than did those without SS (aHR, 1.93). The risk of PD was higher (aHR, 2.20) in patients with SS without comorbidities than in those with comorbidities. The aHR of PD significantly increased when the follow-up period exceeded 9 years (aHR, 1.93). We determined an increased risk of PD in patients with SS. Further investigation is warranted to determine the possible underlying mechanisms and the potential role of non-hydroxychloroquine immunosuppressants in ameliorating PD. Wolters Kluwer Health 2019-04-05 /pmc/articles/PMC6455855/ /pubmed/30946325 http://dx.doi.org/10.1097/MD.0000000000014984 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article Ju, Uei-Han Liu, Feng-Cheng Lin, Chin-Sheng Huang, Wen-Yen Lin, Te-Yu Shen, Chih-Hao Chou, Yu-Ching Lin, Cheng-Li Lin, Kuen-Tze Kao, Chia-Hung Chen, Chao-Hsien Yang, Tse-Yen Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study |
title | Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study |
title_full | Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study |
title_fullStr | Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study |
title_full_unstemmed | Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study |
title_short | Risk of Parkinson disease in Sjögren syndrome administered ineffective immunosuppressant therapies: A nationwide population-based study |
title_sort | risk of parkinson disease in sjögren syndrome administered ineffective immunosuppressant therapies: a nationwide population-based study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455855/ https://www.ncbi.nlm.nih.gov/pubmed/30946325 http://dx.doi.org/10.1097/MD.0000000000014984 |
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