The incidence of dementia in patients with RA was significantly lower in those who took either a biologic or targeted synthetic DMARD, compared to patients who take a conventional synthetic DMARD. RheumTwitter
who took either a biologic disease-modifying antirheumatic drug or targeted synthetic DMARD was significantly lower than the rate observed in patients who take only a conventional synthetic DMARD in a national database study.and related dementias in people with RA. While joint pain and swelling are the cardinal symptoms of RA, its systemic inflammation leads to multiple systemic manifestations, offering biologically plausible links with cognitive decline.
In the study of Centers for Medicare & Medicaid Services claims during 2006-2017 for 141,326 adult patients with RA, the crude incident rates were 2.0 per 100 person-years for patients on csDMARDs and 1.3 for patients on any b/tsDMARD. There were 3,794 cases of incident dementia during follow-up among 233,271 initiations of any DMARD. The adjusted risk for dementia among users of bDMARDs or tsDMARDs was 19% lower than the adjusted risk for patients on csDMARDs .
"NSAIDs and glucocorticoids have been studied in RCTs [randomized, controlled trials]," Sattui said in the interview."Despite initial observational data that showed some signal for improvement, no benefit was observed in either of the RCTs. Other agents with possible anti-inflammatory effects and more benign profiles, such as curcumin, are being studied. There are also ongoing trials looking into the use of JAK [Janus kinase] inhibitors or [interleukin]-1 inhibition in dementia.
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