Unraveling the Link: The Amplified Risk of Parkinson’s Disease in Rheumatoid Arthritis Patients – A Korean Study Perspective

In an investigation done by Kosin University College of Medicine in Korea, a substantial correlation has been unearthed between patients grappling with rheumatoid arthritis (RA) and Parkinson’s disease (PD). The research, showcased in JAMA Neurology, brings to light a significantly amplified risk of Parkinson’s disease in the cohort of patients battling rheumatoid arthritis.

Rheumatoide Arthritis

Rheumatoide Arthritis. Image Courtesy of Bernd Brägelmann

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The investigation, a retrospective cohort analysis, harnessed the Korean National Health Insurance Service database to amass population-based, nationally representative data on patients with RA enrolled from 2010 to 2017 and tracked until 2019. The cohort encompassed 54,680 patients with RA, including 39,010 with seropositive RA and 15,670 with seronegative RA. A five-to-one matching demographic control group of patients devoid of RA was also incorporated, culminating in a total control population of 273,400.

From the comprehensive population of 328,080 scrutinized, 1,093 developed PD (803 controls and 290 with RA). The data divulged that those afflicted with RA had a 1.74-fold higher risk of PD than those without RA. This escalated risk was more pronounced in patients in the seropositive RA group but less elevated in the seronegative RA type.

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These findings are captivating, as they run counter to previous studies on the relationship between the pathologies. For instance, a 2009 Danish Cancer Society population-based case-control study found a decrease in risk for PD of 30%. Similarly, a 2021 study with a Swedish cohort found individuals with a previous diagnosis of RA had a significantly decreased risk of later developing PD by 30%–50% compared to individuals without an RA diagnosis. A 2016 study in Taiwan found 35% lower rates of PD in 33,221 RA patients. However, a 2017 Taiwan study suggested a 14% increased risk.

The researchers of the current study call for further investigations to establish a mechanistic link between RA and PD based on the significant positive correlation in their data. As RA is a highly heritable disease, whereas PD only has genetic markers in about 10% of cases and is thought to be heavily influenced by environmental factors, the potential connection between the two diseases presents an interesting crossroads for research.

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The authors of the study suggest that physicians should be cognizant of the elevated risk of PD in patients with RA and consider prompt referral to a neurologist at the onset of early motor symptoms. With previous studies yielding dramatically different results, it may be that the correlations seen statistically, both positive and negative, are evidence that no mechanism between the two exists. If a connection does exist, further research will be needed to untangle the conflicting data.

In conclusion, this study underscores the importance of continued research into the complex interplay between rheumatoid arthritis and Parkinson’s disease. As we strive to enhance our understanding of these conditions, studies like this one bring us one step closer to developing more effective strategies for diagnosis, treatment, and patient care.

References

Jihun Kang, MD, Ph.D.; Yeonghee Eun, MD, Ph.D.; Wooyoung Jang, MD, PhD3; et al Rheumatoid Arthritis and Risk of Parkinson Disease in Korea. JAMA Neurology. Published online May 1, 2023. doi:10.1001/jamaneurol.2023.0932. Retrieved May 24, 2023, from https://jamanetwork.com/journals/jamaneurology/article-abstract/2804530

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