Inflammatory bowel disease and risk of Parkinson's disease in medicare beneficiaries

Abstract

We thank Dr. Javier Pinel Ríos and colleagues for their interest in our manuscript [ [1] Camacho-Soto A. Gross A. Searles Nielsen S. et al. Inflammatory bowel disease and risk of Parkinson's disease in Medicare beneficiaries. Park. Relat. Disord. 2018; 50: 23-28 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar ] and for their interesting and supportive findings [ [2] Escamilla-Sevilla F. Pinel-Ríos J. Madrid-Navarro C.J. et al. Are inflammatory bowel disease and/or treatment with aminosalicylates protective factors against Parkinson's disease?. Mov. Disord. 2016; 31: S141 Google Scholar ]. Both analyses indicated an inverse association between Parkinson's disease (PD) and inflammatory bowel disease (IBD), despite little difference in ages among PD patients with or without IBD. Similarly, in a more recently published analysis from our group [ [3] Racette B.A. Gross A. Vouri S.M. et al. Immunosuppressants and risk of Parkinson disease. Ann Clin Transl Neurol. 2018; (online ahead of print): 1-6https://onlinelibrary.wiley.com/doi/abs/10.1002/acn3.580 Google Scholar ], we also observed a modestly lower risk of PD in those taking immunosuppressants. There was some evidence that sulfasalazine, and especially mesalamine, might be associated with a modestly lower risk of PD. However, these potential associations were attenuated by exposure lagging and were not specific to this medication class. Nonetheless, we agree that taken together these findings [ 1 Camacho-Soto A. Gross A. Searles Nielsen S. et al. Inflammatory bowel disease and risk of Parkinson's disease in Medicare beneficiaries. Park. Relat. Disord. 2018; 50: 23-28 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar , 2 Escamilla-Sevilla F. Pinel-Ríos J. Madrid-Navarro C.J. et al. Are inflammatory bowel disease and/or treatment with aminosalicylates protective factors against Parkinson's disease?. Mov. Disord. 2016; 31: S141 Google Scholar , 3 Racette B.A. Gross A. Vouri S.M. et al. Immunosuppressants and risk of Parkinson disease. Ann Clin Transl Neurol. 2018; (online ahead of print): 1-6https://onlinelibrary.wiley.com/doi/abs/10.1002/acn3.580 Google Scholar ] might warrant further study on the relationship between immunosuppressant and anti-inflammatory therapies and risk of PD. Inflammatory bowel disease and risk of Parkinson’s diseaseParkinsonism & Related DisordersVol. 57PreviewWe read with interest the paper by Camacho-Soto et al., based on Medicare data [1]. In their case-control study of Parkinson's disease (PD) risk, they observed an inverse association between PD and inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). They also reported that PD was inversely associated with IBD-associated conditions and with IBD-associated surgical procedures and immunosuppressant use, even among Medicare beneficiaries without IBD. They found IBD to be associated with a lower risk of developing PD in the adjusted model for a population aged> 65 years (OR 0.86, 95% CI 0.81–0.92). Full-Text PDF