While systemic inflammation is a potential biological mechanism underlying both Parkinson disease (PD) and inflammatory bowel disease (IBD), clinical data on comorbid PD and IBD are few. In a new study published in JAMA Neurology, researchers report on a retrospective cohort study that assessed the incidence of PD among patients with IBD and sought to identify whether anti–tumor necrosis factor (anti-TNF) therapy for IBD alters the risk of PD.
While systemic inflammation is a potential biological mechanism underlying both Parkinson disease (PD) and inflammatory bowel disease (IBD)—and while the LRRK2 gene has variants that are independently recognized as associated with PD and Crohn disease (CD)—clinical data on comorbid PD and IBD are few. In a new paper published in JAMA Neurology, researchers report on a retrospective cohort study that assessed the incidence of PD among patients with IBD and sought to identify whether anti—tumor necrosis factor (anti-TNF) therapy for IBD alters the risk of PD.
The research team used deidentified data on patients with IBD, 18 years or older, that were derived from the Truven Health MarketScan Commercial Database and the Medicare Supplemental Database from 2000 to 2016. Patients with IBD were matched to 720,090 unaffected controls. Of the total number of individuals, 1796 (0.2%) had PD, and the researchers found a statistically significant 28% increase in the incidence of PD among patients with IBD compared with the control group. The increased rate of PD was observed equally among patients with ulcerative colitis (adjusted incidence rate ratio [IRR], 1.31; 95% CI, 1.14-1.51; P <.001) and CD (adjusted IRR, 1.26; 95% CI, 1.03-1.53; P =.02).
Among patients with IBD who were exposed to anti-TNF therapy (the anti-TNF agents adalimumab, certolizumab, golimumab, and infliximab were included in the analysis), there was a PD incidence rate of 0.08 per 1000 patient-years. Among patients with IBD who were not exposed to anti-TNF agents, the incidence rate of PD per 1000 patient-years was 0.76.
While the exact mechanism of PD development in patients with IBD is not known, the authors conclude that there is a potential link between IBD and PD, and that early exposure to anti-TNF therapy may reduce the risk of PD among patients with IBD, potentially due to a reduction in systemic inflammation.
“In the present study, we observed a 78% reduction in the incidence of PD among patients with IBD who were exposed to anti-TNF medications. These findings call into question the notion that existing anti-TNF therapies have limited central nervous system effects because these large molecule drugs do not cross the blood-brain barrier,” write the authors. “Targeting TNF could have disease-modifying potential in individuals at risk of PD.”
Reference
Peter I, Dubinsky M, Bressman S, et al. Anti—tumor necrosis factor therapy and incidence of Parkinson disease among patients with inflammatory bowel disease [published online April 23, 2018]. JAMA Neurol. doi: 10.1001/jamaneurol.2018.0605.
Challenges, Obstacles, and Future Directions for Anti-TNF Biosimilars in IBD
November 9th 2024A review article on tumor necrosis factor (TNF)-α inhibitors in inflammatory bowel disease (IBD) outlined current use of anti-TNF originators and biosimilars, their efficacy and safety, the benefits and challenges of biosimilars, and the future of biosimilars in IBD.
Biosimilars in America: Overcoming Barriers and Maximizing Impact
July 21st 2024Join us as we explore the complexities of the US biosimilars market, discussing legislative influences, payer and provider adoption factors, and strategies to overcome industry challenges with expert insights from Kyle Noonan, PharmD, MS, value & access strategy manager at Cencora.
Biosimilars Gastroenterology Roundup for May 2024—Podcast Edition
June 2nd 2024On this episode of Not So Different, we review the biggest gastroenterology biosimilar stories from May 2024, covering new data from conferences and journals on infliximab and adalimumab products that demonstrate positive clinical results and confirm the safety of these biosimilars, as well as the feasibility of switching to them.
Panelists Stress Stakeholder Education to Build Confidence in Biosimilars
October 31st 2024By expanding educational initiatives to clarify biosimilar safety, efficacy, and interchangeability, stakeholders can foster trust, improve access, and ensure that biosimilars are widely accepted as high-quality, cost-effective alternatives to originator biologics.