No association between targeted DMARDs and the risk of Alzheimer and related dementia

The research carried out by a team of US researchers have reported no reduction in the risk for Alzheimer disease and related dementia (ADRD) in patients treated with tofacitinib, tocilizumab, or TNF inhibitors  when compared to abatacept.

The study was carried out in 22,569 propensity score-matched patient pairs by  categorizing them into 3 cohorts based on receiving tofacitinib, tocilizumab or TNF inhibitors compared to a common comparator abatacept. No statistically significant associations of ADRD with tofacitinib tocilizumab (analysis 1: HR, 0.82 [95% CI, 0.55-1.21]; analysis 2: HR, 1.05 [95% CI, 0.81-1.35]; analysis 3: HR, 1.21 or TNF inhibitors was noted upon comparison with abatacept. Results of prespecified subgroup analysis based on age, sex, and baseline cardiovascular disease also yielded results, consistent except in patients with cardiovascular disease.

Several previous studies have attempted to quantify the association between  traditional DMARDs, and reduction in ADRD risk. The hypothesis proposed by Drug Repurposing for Effective Alzheimer Medicines (DREAM) have suggested that cytokine signaling, including TNF and interleukin IL-6, via  Janus-kinase (JAK)–signal transducer and activator of transcription pathway, may reduce the risk of Alzheimer disease and related dementia (ADRD).The present study suggesting no association adds to the evidence on drug repurposing questions explored using routine health care data.

 Reference: Desai RJ, Varma VR, Gerhard T, et al. Comparative Risk of Alzheimer Disease and Related Dementia Among Medicare Beneficiaries With Rheumatoid Arthritis Treated With Targeted Disease-Modifying Antirheumatic Agents. JAMA Netw Open. 2022;5(4):e226567.