ATLANTA — Use of tumor necrosis factor inhibitors was associated with a lower rate of Alzheimer's disease in patients with rheumatoid arthritis.
The finding was seen in a nested case-control study. TNF blockers were associated with a 55% reduction in the risk of incident Alzheimer's dementia after adjustment for the presence of known potential risk factors for vascular dementia, including hypertension, hyperlipidemia, diabetes, peripheral vascular disease, and coronary artery disease, said Dr. Richard C. Chou of Dartmouth-Hitchcock Medical Center in Milton, Mass.
Dr. Chou and his colleagues identified 41,109 patients with RA in a commercially insured cohort of 8.5 million adults. Among the RA patients, 458 also had a diagnosis of Alzheimer's disease.
The overall prevalence of dementia in RA patients was 1.11%; the overall prevalence in the cohort without RA was 0.14%.
Exposure to three specific anti-TNF drugs – infliximab, etanercept, and adalimumab – was examined, as was exposure to sulfasalazine, prednisone, and rituximab.
Use of the anti-TNF agents as a group was significantly associated with a reduced risk of Alzheimer's dementia, Dr. Chou said. When the anti-TNF agents were analyzed individually, only etanercept was significantly associated with reduced risk. Etanercept was associated with about a 70% reduction in the risk of Alzheimer's dementia.
Dr. Chou said he had no relevant financial disclosures.