[Translation of JANVAN's German summary, which is slightly more digested than the original English abstract, though they contain much the same info. Now comes the usual question for a protective therapy: "Once the cows have left the barn (you've got the PD), can we bring them back (will the anti-infalmmatory drugs slow, stop, or reverse the disease) ?"]
Anti-inflammatory therapy for intestinal diseases apparently reduces the risk of Parkinson's
Key messages
Patients with inflammatory bowel disease are 28% more likely to develop Parkinson's disease. However, when the intestinal disease is treated with anti-tumor necrosis factor alfa (anti-TNFα), the risk for Parkinson's disease decreases and is even lower than that in the general population.
Background
Inflammatory processes are considered by some experts as a common denominator for both Crohn's disease and ulcerative colitis as well as for Parkinson's disease, which according to a new theory could take its course from the intestine. This assumption would be supported if a reduction in the inflammatory process with drugs lowers the likelihood of later Parkinson's disease - a hypothesis that is being reviewed in the current study.
Design
Retrospective cohort study based on data on the reimbursement claims of more than 170 million patients in the US for the period January 2000 to March 2016. Individuals without Parkinson's disease were selected with at least 2 claims for the diagnosis of inflammatory bowel disease and at least 6 months follow-up. The primary study goals were the incidence rates for individuals with and without inflammatory bowel disease with and without anti-TNFα therapy
Clinical significance
The study is another indication that Parkinson's disease has an early inflammatory component and could originate from the gut. The immediate impact on the practice is still low. Although the authors suggest that their findings provide the basis for better screening of patients with inflammatory bowel disease, not all experts are likely to consider the 28% relative risk increase to be adequate. Closer to this, another suggestion is to test the benefit of anti-TNFα therapy in individuals with a high risk of Parkinson's disease in a controlled trial.
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