Potential long-term effect of tumor necrosis factor inhibitors on dementia risk: A propensity score matched retrospective cohort study in US veterans

Alzheimers Dement. 2022 Jun;18(6):1248-1259. doi: 10.1002/alz.12465. Epub 2021 Sep 27.

Abstract

Introduction: Tumor necrosis factor (TNF) inhibitors are widely used to treat rheumatoid arthritis (RA) and their potential to retard Alzheimer's disease (AD) progression has been reported. However, their long-term effects on the dementia/AD risk remain unknown.

Methods: A propensity scored matched retrospective cohort study was conducted among 40,207 patients with RA within the US Veterans Affairs health-care system from 2000 to 2020.

Results: A total of 2510 patients with RA prescribed TNF inhibitors were 1:2 matched to control patients. TNF inhibitor use was associated with reduced dementia risk (hazard ratio [HR]: 0.64, 95% confidence interval [CI]: 0.52-0.80), which was consistent as the study period increased from 5 to 20 years after RA diagnosis. TNF inhibitor use also showed a long-term effect in reducing the risk of AD (HR: 0.57, 95% CI: 0.39-0.83) during the 20 years of follow-up.

Conclusion: TNF inhibitor use is associated with lower long-term risk of dementia/AD among US veterans with RA.

Keywords: Alzheimer's disease; US veterans; cohort study; dementia; long-term effect; rheumatoid arthritis; tumor necrosis factor inhibitor.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antirheumatic Agents* / adverse effects
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / drug therapy
  • Arthritis, Rheumatoid* / epidemiology
  • Dementia* / chemically induced
  • Dementia* / epidemiology
  • Dementia* / prevention & control
  • Humans
  • Propensity Score
  • Retrospective Studies
  • Tumor Necrosis Factor Inhibitors
  • Veterans*

Substances

  • Antirheumatic Agents
  • Tumor Necrosis Factor Inhibitors