Evidence map›Paper›PMID 40088377›Full record

ReviewDrugs & aging2025

Impact of Disease-Modifying Antirheumatic Drugs on Cognitive Function in Older Adults with Rheumatoid Arthritis.

Seyedeh D Fazel, Massimo Carollo, Lisanne Tap, Andrea Spini, Gianluca Trifirò, Francesco U S Mattace-Raso

Abstract readReview
In one paragraph

Review in Drugs & aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Seyedeh D FazelSection of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Room Rg-525, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Massimo CarolloSection of Pharmacology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Lisanne TapSection of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Room Rg-525, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Andrea SpiniSection of Pharmacology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Gianluca TrifiròSection of Pharmacology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Francesco U S Mattace-RasoSection of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Room Rg-525, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands. f.mattaceraso@erasmusmc.nl.ORCID 0000-0002-1688-6497

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cognitive impairment poses significant challenges for aging populations. Systemic inflammation, a hallmark of rheumatoid arthritis (RA), has been implicated in neurodegeneration through mechanisms including blood-brain barrier disruption, microglial activation, and cytokine-mediated neuronal damage. This review examines the potential impact of disease-modifying antirheumatic drugs (DMARDs) on cognitive function in RA, focusing on the inflammatory pathways linking systemic inflammation to neuroinflammation and cognitive decline. DMARDs, categorized into conventional synthetic (csDMARDs), biologic (bDMARDs), and targeted synthetic (tsDMARDs) classes, modulate immune responses through distinct mechanisms. Evidence suggests that DMARDs, particularly bDMARDs targeting proinflammatory cytokines such as TNF-α and IL-6, may mitigate neuroinflammatory processes and preserve cognitive function. However, the cognitive impact of csDMARDs such as methotrexate is complex, with conflicting reports regarding its role in vascular dementia. Emerging therapies such as Janus kinase inhibitors (JAK-i) offer promise in modulating central inflammation, though clinical evidence remains limited. While some studies highlight protective effects of DMARDs against dementia, findings are inconsistent, hindered by heterogeneity in study design, patient demographics, and cognitive assessment methods. This review underscores the need for personalized treatment strategies, integrating RA management with cognitive health considerations. Future research should prioritize robust, prospective studies with long-term follow-up, incorporating neuroimaging and biomarker analysis to elucidate the mechanisms underpinning DMARD-associated cognitive outcomes. A better understanding of the involved inflammatory pathways in RA and the potential effects of DMARDs could lead to improved therapeutic approaches, enhancing quality of life for patients with RA and potentially benefiting broader strategies in preventing or treating dementia.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidCognitionCognitive DysfunctionAgedHumansAntirheumatic Agents

Identifiers

PMID40088377
PMCPMC12003462

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.