title: Prolong Exposure of NSAID in Patients With RA Will Decrease the Risk of Dementia: A Nationwide Population-Based Cohort Study.
abstract: Rheumatoid arthritis (RA), a chronic, systemic inflammatory disorder, primarily affects joints. Several studies have indicated that early inflammation, cardiovascular disease, and depression in patients were associated with a considerably increased risk of dementia. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for treating RA. NSAIDs facilitate alleviating RA-associated chronic pain, inflammation, and swelling. Therefore, we conducted this nationwide study for evaluating the association between the dementia risk and NSAID treatment in patients with RA.The RA cohort comprised patients aged 20 years and older who were newly diagnosed with RA between 2000 and 2011, with data obtained from the Registry of Catastrophic Illnesses Patient Database (RCIPD). Patients without RA were frequency matched with the RA cohort at a 1:4 ratio according to age, sex, and year of RA diagnosis. The relative risks of dementia were estimated using Cox proportional hazard models.The risk of dementia in the RA cohort was not significantly higher than that in the non-RA cohort (adjusted HR [hazard ratio] = 0.95, 95% confidence interval [CI] = 0.87-1.02). Regarding the duration of NSAID treatment, the risk of dementia was significantly lower when the RA cohort used NSAIDs for >2191 days (HR = 0.56, 95% CI = 0.45-0.68).A longer duration of NSAID treatment possibly reduces the risk of dementia. Additional studies are warranted for verifying the association of dementia risk with NSAID treatment in patients with RA.
authors.affiliation: From the Department of Public Health (K-HC), China Medical University, Taichung; Institute of Biomedical Sciences (Y-CH), Mackay Medical College, Taipei; Department of Medical Research (C-CH), Taichung Veterans General Hospital; Management Office for Health Data (C-LL), China Medical University Hospital; Graduate Institute of Clinical Medical Science (CYH, C-HK), China Medical University, Taichung; School of Chinese Medicine for Post-Baccalaureate (C-YL), I-Shou University, Kaohsiung; Division of Hepatology and Gastroenterology (L-WC), Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; Respiratory Therapy Intensive Care Unit (H-CL), Taichung Veterans General Hospital, Taichung; Department of Nuclear Medicine (M-CL), E-Da Hospital, I-Shou University, Kaohsiung; and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung, Taiwan.
authors.forename: Kuang-Hsi
authors.initials: KH
authors.lastname: Chang
authors.forename: Yi-Chao
authors.initials: YC
authors.lastname: Hsu
authors.forename: Chih-Chao
authors.initials: CC
authors.lastname: Hsu
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Chung Y
authors.initials: CY
authors.lastname: Hsu
authors.forename: Chang-Yin
authors.initials: CY
authors.lastname: Lee
authors.forename: Lee-Won
authors.initials: LW
authors.lastname: Chong
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Liu
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Lin
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D003704:Dementia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal