Association of Tumor Necrosis Factor-α Inhibitors with Incident Dementia: Analysis Based on Population-Based Cohort Studies

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Saskia Berger - , Pharmacy, Center for Evidence-Based Healthcare (Author)
  • Kristine F. Moseholm - , University of Copenhagen (Author)
  • Emilie R. Hegelund - , University of Copenhagen (Author)
  • Falko Tesch - , Center for Evidence-Based Healthcare (Author)
  • Minh Chau S. Nguyen - , University of Copenhagen (Author)
  • Laust H. Mortensen - , University of Copenhagen (Author)
  • Majken K. Jensen - , University of Copenhagen, Boston University (Author)
  • Jochen Schmitt - , Center for Evidence-Based Healthcare (Author)
  • Kenneth J. Mukamal - , Beth Israel Deaconess Medical Center (BIDMC), Boston University (Author)

Abstract

Background and Objective: Preliminary evidence suggests a possible preventive effect of tumor necrosis factor-α inhibitors (TNFi) on incident dementia. The objective of the analysis was to investigate the association between TNFi and the risk of incident dementia in a population undergoing treatment for rheumatological disorders. Methods: We followed patients aged ≥ 65 years with dementia and rheumatological conditions in two cohort studies, DANBIO (N = 21,538), a Danish clinical database, and AOK PLUS (N = 7112), a German health insurance database. We defined incident dementia using diagnostic codes and/or medication use and used Cox regression to compare the associations of TNFi with other rheumatological therapies on the risk of dementia. To ensure that the patients were receiving long-term medication, we included patients with rheumatic diseases and systemic therapies. Results: We observed similar trends towards a lower risk of dementia associated with TNFi versus other anti-inflammatory agents in both cohorts (hazard ratios were 0.92 [95% confidence interval 0.76, 1.10] in DANBIO and 0.89 [95% confidence interval 0.63, 1.24] in AOK PLUS, respectively). Conclusions: Tumor necrosis factor-α inhibitors may decrease the risk of incident dementia although the association did not reach statistical significance in this analysis. Further research, ideally with randomization, is needed to gauge the potential of repurposing TNFi for dementia prevention and/or treatment.

Details

Original languageEnglish
Number of pages8
Journal Drugs & aging : evaluations of age-related changes in drug disposition and drug therapy in the elderly
Volume41
Issue number5
Publication statusPublished - 12 Apr 2024
Peer-reviewedYes

External IDs

Scopus 85190111504

Keywords