Abstract Details

Title Association of Anti-inflammatory Therapy Use with the Incidence of Parkinson’s Disease: A Person-Time Analysis Among Patients with Autoimmune Diseases

Topic Movement Disorders

Presentation(s) S2 - Movement Disorders: Epidemiology and Clinical Aspects (1:24 PM-1:36 PM)

Poster/Presentation
Number 003

Background

PD incidence is higher in autoimmune patients, necessitating further investigation of the impact of anti-inflammatory drug exposure.

Objective Investigate the correlation between Parkinson’s Disease (PD) occurrence and exposure to anti-inflammatory medications, specifically anti-tumor necrosis factor (anti-TNF) and anti-interleukin (IL)-17, in individuals diagnosed with autoimmune conditions (rheumatoid arthritis, ulcerative colitis, Crohn’s disease, ankylosing spondylitis, or psoriasis/psoriatic arthritis).

Design/Methods In this retrospective cohort study, we leveraged data from the US Komodo Health claims database to identify individuals diagnosed with autoimmune diseases between 2015 and 2022. To assess the comparative risk of PD associated with exposure to anti-TNF/anti-IL-17 treatments, two patient cohorts were delineated: exposed to specified anti-inflammatory therapy and unexposed. Person-time incidence rates of PD were computed, and incidence rate ratios (IRRs) were derived for association analysis. Person-time incidence rates per 100 person-years (PY) across quintiles of anti-TNF/anti-IL-17 exposure were calculated.

Results Among 2,105,677 autoimmune patients, 114,082 received anti-TNF/anti-IL-17 treatment, while 1,991,595 remained untreated. PD incidence was 0.661 per 100-PY in the exposed cohort compared to 0.949 per 100-PY in the unexposed cohort. The IRR comparing the exposed to the unexposed was 0.696 (95% CI: 0.669, 0.724). PD incidence rates for anti-inflammatory drug recipients were: anti-TNF only - 0.665 (95% CI: 0.639, 0.692), and anti-IL-17 only - 0.519 (95% CI: 0.412, 0.645. The IRR between anti-IL-17 and anti-TNF therapy indicated that patients treated with anti-IL-17 had a lower risk of developing PD (0.781 [95% CI: 0.626, 0.975)]. Analysis of person-time incidence rates revealed a potential treatment-response relationship, with an incidence rate of 5.295 (95% CI: 4.937, 5.673) in the lowest exposure quintile and 0.158 per 100-PY (95% CI: 0.139, 0.179) in the highest exposure quintile.

Conclusions

Our findings suggest that anti-TNF/anti-IL-17 treatment in patients with autoimmune disease reduces PD incidence, indicating that the mitigation of systemic inflammation could potentially lower the risk of developing PD.

Authors/Disclosures
Michele Potashman, PhD (Biohaven) PRESENTER	Dr. Potashman has received personal compensation for serving as an employee of Biohaven Pharmaceuticals.
Jennifer Haas (Xcenda GmbH, part of Cencora Inc.)	No disclosure on file
Ambrish Pandit (Cencora)	No disclosure on file
Dana Stafkey-Mailey	No disclosure on file
Vladimir Coric	Vladimir Coric has received personal compensation for serving as an employee of Biohaven. Vladimir Coric has received personal compensation in the range of $1,000,000+ for serving as an officer or member of the Board of Directors for Bioahven. Vladimir Coric has stock in Biohaven. Vladimir Coric has received intellectual property interests from a discovery or technology relating to health care.
Wolfgang Singer, MD (Mayo Clinic)	Dr. Singer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Singer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UniQure. Dr. Singer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Singer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theravance. The institution of Dr. Singer has received research support from NIH. The institution of Dr. Singer has received research support from FDA. The institution of Dr. Singer has received research support from Michael J. Fox Foundation. Dr. Singer has received intellectual property interests from a discovery or technology relating to health care.
Gilbert J. L'Italien	Gilbert J. L'Italien has received personal compensation for serving as an employee of Biohaven Pharmaceuticals. Gilbert J. L'Italien has stock in biohaven pharmaceuticals.