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Thiazolidinedione use is associated with reduced risk of Parkinson’s disease in patients with diabetes

S. Hussain, A. Singh, H. Baxi, B. Taylor, J. Burgess, B. Antony (Delhi, India)

Meeting: MDS Virtual Congress 2020

Abstract Number: 191

Keywords: Drug-induced parkinsonism(DIP), Neuroprotective agents, Parkinsonism

Category: Epidemiology

Objective: This meta-analysis is aimed to explore the association between thiazolidinedione (TZD) use and Parkinson’s disease (PD) risk.

Background: Recent epidemiological studies found protective effects of TZD class of drugs in PD. However, there are studies which found no beneficial effects of TZD in PD patients. It remains controversial whether TZD is protective against PD or not.

Method: Literature search was performed in PubMed, Embase, and Cochrane central from inception to till September 2019. We included all the real-world evidence studies assessing the exposure to TZD use and risks of PD in people with diabetes. Data were extracted by one reviewer and checked by another reviewer. Quality of the studies was evaluated using Newcastle-Ottawa scale. The primary outcome was the incidence of PD among type-2 DM TZD users as compared to TZD non-users in people with diabetes. The secondary outcome was the incidence of PD among type-2 DM TZD users as compared to non-users (include both diabetic and non-diabetic population). Meta-analysis was performed using RevMan Software.

Results: Out of five studies selected for inclusion four studies fulfilled the criteria for primary outcomes with 312,294 overall participants including 66,129 TZD users. The participants’ mean age and follow-up duration was 66.23 ± 9.59 years and 5.25 years (2.97-7.9 years), respectively. There was a significant reduction in the risk of PD (pooled adjusted relative risk (RR) of 0.81 [95% CI: 0.70 – 0.93, p = 0.004]) in TZD users compared to non-TZD users in patients with diabetes. The subgroup analysis based on the follow-up duration (>5 years) showed a significant reduction in the incidence of PD in TZD users (2 studies) [RR 0.60 (95% CI: 0.41 – 0.89), p = 0.01] as compared to non-usersA significant protective effect of TZD was observed in Caucasian population (3 studies) RR 0.79 (95% CI: 0.65 – 0.97), p = 0.02. The protective effect of TZD was retained when subgroup analysis, with studies constituting non-diabetic population in non-exposure arms, was performed (RR: 0.72, 95%CI: 0.53 – 0.98, p = 0.04).

Conclusion: This meta-analysis based on real-world evidence suggests a protective effect of TZD for PD risk in diabetic populations.

To cite this abstract in AMA style:

S. Hussain, A. Singh, H. Baxi, B. Taylor, J. Burgess, B. Antony. Thiazolidinedione use is associated with reduced risk of Parkinson’s disease in patients with diabetes [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/thiazolidinedione-use-is-associated-with-reduced-risk-of-parkinsons-disease-in-patients-with-diabetes/. Accessed June 15, 2025.
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