Methotrexate associated with reduced dementia risk in RA patients
medwireNews: The use of conventional DMARDs, especially methotrexate, is associated with a reduced risk for dementia among patients with rheumatoid arthritis (RA), researchers report.
Andy Judge (University of Oxford, UK) and team analyzed electronic primary care medical records from 3876 RA patients who received treatment with conventional DMARDs and 1938 propensity score-matched patients who did not use DMARDs. Patients in the two groups were followed up for a median of 6.5 years and 5.1 years, respectively.
The team observed a “strong reduction” in the risk for dementia among patients treated with DMARDs. Compared with nonusers, the overall population of DMARD-treated patients had a significant 40% reduced risk for dementia, while the 2355 patients who were treated with methotrexate had a 48% reduced risk.
“Whether the lower dose [of methotrexate] as used in clinical practice for RA would be sufficient to cross the blood-brain barrier to have a central effect in [Alzheimer’s disease] protection, or whether the strong protection observed in this study suggests instead a peripheral action, raises a number of important questions for further study,” say the researchers.
And they conclude in Alzheimer's & Dementia: Translational Research & Clinical Interventions: “The strong effect of [conventional] DMARD use on halving of dementia risk requires replication in a trial and may provide an important therapeutic pharmacological treatment.”
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