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Neurology
Research
Association of Parkinson’s disease and treatment with aminosalicylates in inflammatory bowel disease: a cross-sectional study in a Spain drug dispensation records
  1. Javier Pinel Ríos1,
  2. Carlos Javier Madrid Navarro2,
  3. María José Pérez Navarro2,
  4. María José Cabello Tapia3,
  5. María José Piña Vera4,
  6. Víctor Campos Arillo1,
  7. María Rosario Gómez García3,
  8. Adolfo Mínguez Castellanos2,
  9. Francisco Escamilla Sevilla2
  1. 1 Neuroscience Unit, Hospital Vithas Xanit Internacional, Benalmadena, Spain
  2. 2 Department of Neurology, Hospital Universitario Virgen de las Nieves, Granada, Spain
  3. 3 Department of Digestive Diseases, Hospital Universitario Virgen de las Nieves, Granada, Spain
  4. 4 Andalusian Health Service Pharmacy and Benefit Support Department, Andalusian Health Service, Government of Andalusia, Sevilla, Spain
  1. Correspondence to Dr Javier Pinel Ríos; javierpinelr{at}gmail.com

Abstract

Objectives To analyse the association between aminosalicylate-treated inflammatory bowel disease (IBD) and Parkinson’s disease (PD) at population level.

Design Cross-sectional study.

Setting The study was performed based on electronic drug prescription and dispensation records of the Andalusian Public Health System.

Participants All individuals aged ≥50 years with at least one drug dispensation during December 2014 were identified from the records.

Primary and secondary outcome measures Groups were formed: ‘possible PD’ group, including all who received an anti-Parkinson agent; ‘possible IBD’ group, those treated with mesalazine and/or derivatives (5-aminosalicylic acid (5-ASA)); and ‘possible PD and IBD’, including those receiving both anti-Parkinson agent and 5-ASA. Prevalence of possible PD was determined among those with possible IBD and among those without this condition. The age-adjusted and sex-adjusted OR was calculated.

Results We recorded 2 020 868 individuals (68±11 years, 56% female), 19 966 were included in possible PD group (75±9 years, 53% female) and 7485 in possible IBD group (64±10 years, 47% female); only 56 were included in both groups (76±8 years, 32% female). The prevalence of possible PD was 0.7% among those with possible IBD and 1% among those without this condition (adjusted OR=0.94; 95% CI 0.72 to 1.23; p=0.657). OR was 0.28 in individuals aged ≤65 years (95% CI 0.10 to 0.74; p=0.01) and 1.17 in older individuals (95% CI 0.89 to 1.54; p=0.257).

Conclusions Within the limitations of this study, the results suggest a protective role for IBD and/or 5-ASA against PD development, especially among under 65-year olds. Further studies are warranted to explore this association given its scientific and therapeutic implications.

  • 5-ASA
  • Parkinson’s disease
  • inflammatory bowel disease
  • alpha-synuclein
  • microbiota
  • prevalence

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-025574

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    Footnotes

    • Contributors JPR, FES and VCA contributed conception and design of the study. MJPN, MJPV and CJMN organised the database. FES and AMC performed the statistical analysis. JPR wrote the first draft of the manuscript. FES, CJMN, MJCT and MRGG wrote sections of the manuscript. All authors contributed to manuscript revision, read and approved the submitted version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval The study was approved by the Research Ethics Committee of Granada (CEI-GRANADA).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional unpublished data from the study.

    • Patient consent for publication Not required.