INTRODUCTION: Despite the widespread adoption of incretin-based therapy (IBT) for type 2 diabetes (T2D) and weight management, its potential neuroprotective effects remain inadequately characterized. Given emerging evidence of IBT's effects on neurodegenerative pathways, determining its association with Parkinson's disease (PD) incidence could have major clinical implications. We investigated the association between IBT and PD incidence in patients with T2D.
METHODS: This retrospective cohort study identified patients with T2D between January 2008 and December 2021 who were classified as users or non-users of IBT based on time-dependent exposure and were followed for incident PD until December 2022. Additionally, a systematic literature review and meta-analysis were conducted.
RESULTS: We identified 86,105 patients with T2D, of those, 347 patients developed PD. IBT use was associated with a decreased risk of PD (Hazard Ratio [HR] = 0.76, 95 % Confidence Interval [CI]:0.59-0.98), but this effect did not remain significant after confounders control (HR = 0.87, 95 % CI:0.65-1.15). The meta-analysis, comprising 12 studies and 964,446 patients, including our current cohort, revealed that IBT use was associated with a 30 % lower risk of PD (RR = 0.70, 95 % CI:0.56-0.87). This effect was more pronounced in studies including younger subjects and those with shorter T2D duration at baseline.
CONCLUSIONS: The current findings suggest a negative relationship between IBT and risk of PD among patients with T2D, particularly in younger age group with short duration of the disease.