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Autophagy is an intracellular pathway by which cells generate energy and metabolites by recycling their own non-essential, redundant or damaged components.1 Pathophysiological studies have demonstrated that the impairment of autophagy contributes to protein aggregate accumulation that occurs during Alzheimer’s disease and experiments have shown that autophagy inhibitors, such as chloroquine and hydroxychloroquine, block amyloid plaque degradation.1 2 Further, a recent case–control study found that patients with rheumatoid arthritis who used hydroxychloroquine were at increased risk of dementia.3 We investigated whether chronic exposure to chloroquine/hydroxychloroquine increases the risk of Alzheimer’s disease.
Data from The Health Improvement Network (THIN) were used (January 1990–December 2016). THIN is a UK primary care database on >12 million people. Participating general practitioners prospectively enter clinical information on individuals so that the database provides a longitudinal medical record for each individual. THIN is representative of the UK population. …
Handling editor Josef S Smolen
Contributors LF, IN and IP: contributed to the concept and design of the work; acquisition, analysis and interpretation of data for the work; participated in the drafting of the work and revised it for important intellectual content; and gave final approval of the version to be published.
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 National Health Service South-East Multicentre Research Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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