Anti–Tumor Necrosis Factor Therapy and Incidence of Parkinson Disease Among Patients With Inflammatory Bowel Disease
Open accessAbstract
Importance: Despite established genetic and pathophysiologic links between inflammatory bowel disease (IBD) and Parkinson disease (PD), clinical data supporting this association remain scarce. Although systemic inflammation is considered a potential biological mechanism shared between the 2 diseases, the role of reduced systemic inflammation through IBD-directed anti-tumor necrosis factor (anti-TNF) therapy in PD risk is largely unknown. Objective: To compare the incidence of PD among individuals with or without IBD and to assess whether PD risk among patients with IBD is altered by anti-TNF therapy. Design, Setting, and Participants: This is a retrospective cohort study analyzing information in the Truven Health MarketScan administrative claims database and the Medicare Supplemental Database between January 1, 2000, and March 31, 2016. Individuals were selected who had at least 2 claims for IBD diagnoses, at least 6 months of follow-up, and no prior diagnosis of PD on or before the IBD index date. Exposure to Anti-TNF therapy was measured from the anti-TNF index date to the last date of anti-TNF coverage or the end of enrollment or PD index date, whichever was earliest. Incidence rates per 1000 person-years were calculated, and crude and adjusted incidence rate ratios were estimated by Poisson regression models and presented with 95% CIs. Main Outcomes and Measures: Incidence of PD among patients with IBD with or without exposure to anti-TNF therapy. Results: In total, 144 018 individuals with IBD were matched on age, sex, and year of index date with 720 090 unaffected controls. Of them, 1796 individuals had at least 2 PD diagnoses and at least 1 filled PD-related prescription. The mean (SD) age of individuals with IBD was 51 (17) years, and 44% were men. The incidence of PD among patients with IBD was 28% higher than that among unaffected matched controls (adjusted incidence rate ratio, 1.28; 95% CI, 1.14-1.44; P < .001). A 78% reduction in the incidence rate of PD was detected among patients with IBD who were exposed to anti-TNF therapy compared with those who were not exposed (adjusted incidence rate ratio, 0.22; 95% CI, 0.05-0.88; P = .03). Conclusions and Relevance: A higher incidence of PD was observed among patients with IBD than among individuals without IBD. Early exposure to antiinflammatory anti-TNF therapy was associated with substantially reduced PD incidence. These findings support a role of systemic inflammation in the pathogenesis of both diseases. Further studies are required to determine whether anti-TNF treatment administered to high-risk individuals may mitigate PD risk.
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Large data studies have revealed an elevated risk of PD in individuals with IBDs such as Crohn's disease and ulcerative colitis.
“Large data studies have revealed an elevated risk of PD in individuals with IBDs such as Crohn’s disease and ulcerative colitis [25, 26]”
From The gut–brain axis in early Parkinson’s disease: from prodrome to prevention (2025) · cites this paper as [25]
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Noh, H., Jang, J., Kwon, S., Cho, S.-Y., Jung, W.-S., Moon, S.-K., Park, J.-M., Ko, C.-N., Kim, H., & Park, S.-U. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9082422 · Cited by 8 · see citing works
- Authors
- Peter, I., Dubinsky, M., Bressman, S., Park, A., Lu, C., Chen, N., & Wang, A.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- AbbVie (United States) (US)
- Corresponding author
- Peter, Inga
- Venue
- JAMA Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2018-08-01
- Volume
- 75
- Issue
- 8
- Pages
- 939
- ISSN
- 2168-6149 (ISSN-L)
- PMC
- PMC6142934
- OpenAlex
- W2802836877
- Cited by
- 386
- References
- 59
- Citations by year
- 2026: 23 · 2025: 51 · 2024: 54 · 2023: 43 · 2022: 49 · 2021: 68 · 2020: 42 · 2019: 37 · 2018: 18 · 2012: 1
- FWCI
- 25.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1s10od018522-01)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Keywords
- Parkinson's disease, inflammatory bowel disease, anti-tumor necrosis factor therapy, systemic inflammation, disease risk reduction, administrative claims data, incidence rate ratio
- MeSH terms
- Certolizumab Pegol, Adalimumab, Infliximab, Leucine-Rich Repeat Serine-Threonine Protein Kinase-2, Adolescent, Adult, Aged, Anti-Inflammatory Agents, Antibodies, Monoclonal, Female, Humans, Male, Middle Aged, Parkinson Disease, Tumor Necrosis Factor-alpha, United States, Inflammatory Bowel Diseases, Cohort Studies, Incidence, Young Adult, Protective Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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