期刊
MEDICINE
卷 98, 期 14, 页码 -出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000014984
关键词
longitudinal health insurance database; national health insurance research database; Parkinson disease; Sjogren syndrome
资金
- Ministry of Health and Welfare, Taiwan [MOHW108-TDU-B-212-133004]
- China Medical University Hospital
- Academia Sinica Stroke Biosignature Project [BM10701010021]
- MOST Clinical Trial Consortium for Stroke [MOST 107-2321-B-039-004]
- Tseng-Lien Lin Foundation, Taichung, Taiwan
- Katsuzo and Kiyo Aoshima Memorial Funds, Japan
- Management Office for Health Data, China Medical University Hospital, Taichung
To determine the incidence and risk of Parkinson disease (PD) in patients with Sjogren syndrome (SS) according to a nationwide population-based database. In total, 12,640 patients in the SS cohort and 50,560 in the non-SS cohort were enrolled from Taiwan's National Health Insurance Research Database from 2000 to 2010. We used the Cox multivariable proportional hazards model to determine the risk factors for PD in the SS cohort. We observed an increased incidence of PD in patients with SS, with a crude hazard ratio (HR) of 1.40 and an adjusted HR (aHR) of 1.23. The cumulative incidence of PD was 1.95% higher in the SS cohort than in the non-SS cohort. The SS cohort had an elevated HR under medication use, namely cevimeline and pilocarpine (crude HR, 1.28), hydroxychloroquine (crude HR, 1.43; aHR, 1.46), and methylprednisolone (crude HR, 2.21; aHR, 1.49). Patients receiving other non-hydroxychloroquine immunosuppressant therapies had a lower risk (aHR, 0.86) of PD. Furthermore, patients with SS aged 20 to 49 years had a 1.93-fold higher risk of PD than did those without SS (aHR, 1.93). The risk of PD was higher (aHR, 2.20) in patients with SS without comorbidities than in those with comorbidities. The aHR of PD significantly increased when the follow-up period exceeded 9 years (aHR, 1.93). We determined an increased risk of PD in patients with SS. Further investigation is warranted to determine the possible underlying mechanisms and the potential role of non-hydroxychloroquine immunosuppressants in ameliorating PD.
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