DMARDs for rheumatoid arthritis linked to lower dementia risk

Research published in Rheumatic & Musculoskeletal Disease found that patients with rheumatoid arthritis (RA) who were taking biological disease-modifying antirheumatic drugs (DMARDs) had a 24% lower risk of dementia.

Previous studies have linked RA with an elevated risk of dementia, identifying chronic systemic inflammation and dysregulation of inflammatory cytokines as factors in RA pathogenesis, while modulating systemic inflammation has been associated with reduced dementia development.

Understanding the link between these two factors, researchers hoped to assess how medications used to manage RA and minimize inflammation — such as DMARDs, including tumor necrosis factor (TNF) inhibitors and non-TNF biologics — can impact dementia risk.

According to the study, biological DMARDs were better at minimizing dementia risk than synthetic DMARDs, reducing the risk by 24%. In addition, the research pointed out that both TNF inhibitor and non-TNF biologics reduced dementia risk by the same rate.

The investigators compared differences between biological DMARDs (bDMARDs), conventional synthetic DMARDs (csDMARDs), and targeted synthetic DMARDs (tsDMARDs).

“The present study provides comprehensive evidence on the beneficial effects of bDMARDs, however, not csDMARDs, on dementia development in patients with RA. These findings have clinical implications in choosing DMARDs for patients with RA at high risk for dementia and may also provide important insights into the prevention and treatment of dementia. Controlled clinical trials on TNF inhibitors are necessary to test their neuroprotective potentials,” concluded researchers in the study.

As dementia rates continue to climb globally and across the United States, new research on minimizing the risk of dementia is becoming increasingly valuable. According to the study, 152 million people are expected to have dementia by 2050. Additionally, global spending on dementia has risen by 4.5% annually.

With more insights, researchers may be able to establish a more vital link between dementia and inflammation. If so, future studies may assess how anti-inflammatory biologics and biosimilars, such as those used to treat RA, can be repurposed to manage and prevent dementia.