Alcohol use disorder (AUD), epilepsy, hemorrhagic stroke (HS), and traumatic brain injury (TBI) are all linked to neuroinflammation and associated with an increased risk of Alzheimer's disease (AD). Drug responses in cognitive health remain largely unknown in patients with neuroinflammation-related conditions.
Objective
To investigate the associations between drug exposure and AD incidence in patients with neuroinflammation-related conditions.
Methods
We derived covariate matched cohorts for individuals with and without neuroinflammation-related conditions (e.g., AUD, epilepsy, HS and TBI) from a US nationwide insurance claim data. We used covariate-adjusted Cox models to estimate the hazard ratios (HRs) of drug exposure on AD. We identified neuroinflammation-specific drug responses by comparing HRs between individuals with and without neuroinflammation-related conditions.
Results
We identified 0.4 million matched pairs of individuals with and without neuroinflammation-related conditions. We identified three drugs (levothyroxine [HR = 0.89], mirabegron [HR = 0.69], and ropinirole [HR = 0.81]) had a lower HR and two drugs (levetiracetam [HR = 1.19], and quetiapine [HR = 1.83]) had a higher HR in individuals with neuroinflammation-related conditions compared to without (false discovery rate <0.05).
Conclusions
In patients with neuroinflammation-related conditions, we identified drugs associated with lower risks (levothyroxine, mirabegron and ropinirole) and higher risks (levetiracetam and quetiapine) of AD incidence.
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