Could Immunosuppressants Prevent Parkinson Disease?

Taking immunosuppressants is associated with a decreased likelihood of development of Parkinson disease, according to a recent study.

In a previous study, researchers created a PD predictive model that identified a number of diagnoses treated with immunosuppressants that were inversely associated with PD. To further explore this relationship, they conducted a population-based case-control study using Medicare claims data from patients aged 50 to 90 years in 2009 with prescription data (48,295 PD cases and 52,324 controls).

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The researchers identified 7 immunosuppressant drug classes and 26 specific medications used by the participants before PD diagnosis: calcineurin inhibitors (cyclosporine, tacrolimus); Inosine monophosphate dehydrogenase (IMDH) inhibitors (azathioprine, leflunomide, mycophenolate); dihydrofolate reductase inhibitors (methotrexate); biologics (abatacept, adalimumab, anakinra, certolizumab, etanercept); corticosteroids (prednisone, prednisolone, methylprednisolone, dexamethasone, cortisone, hydrocortisone); and miscellaneous (hydroxychloroquine, sulfasalazine, mesalamine, interferon beta‐1a, thalidomide, lenalidomide, glatiramer acetate, flingolimod, and dimethyl fumarate).

Overall, inosine monophosphate dehydrogenase inhibitors (relative risk 0.64) and corticosteroids (relative risk 0.80) were both associated with a lower risk of PD. The inverse associations for both medications remained after applying a 12-month exposure lag.

“In this large population‐based study, use of immunosuppressants, namely corticosteroids and IMDH inhibitors, was associated with a lower risk of PD, even after imposing an “exposure” lag.”

—Michael Potts

References:

1. Racette BA, Gross A, Vouri SM, et al. Immunosuppressants and risk of Parkinson disease [published online May 31, 2018]. Ann Clin Transl Neurol. https://doi.org/10.1002/acn3.580

2. Searles Nielsen S, Warden MN, Camacho‐Soto A, et al. A predictive model to identify Parkinson disease from administrative claims data. Neurology 2017;89:1448–1456.