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. 2023 Feb 10;12(4):1405.
doi: 10.3390/jcm12041405.

Does Having Rheumatoid Arthritis Increase the Dose of Depression Medications? A Mendelian Randomization Study

Xianjie Wan  1 , Jiale Xie  1 , Mingyi Yang  1 , Hui Yu  1 , Weikun Hou  1 , Ke Xu  1 , Jiachen Wang  1 , Peng Xu  1
Affiliations

Does Having Rheumatoid Arthritis Increase the Dose of Depression Medications? A Mendelian Randomization Study

Xianjie Wan et al. J Clin Med. .

Abstract

Background: Rheumatoid arthritis (RA) increases the risk of depression. However, studies on the effects of RA on the dose of depression medications are limited. Therefore, in this study, we used two-sample Mendelian randomization (MR) to explore whether RA increases the dose of depression medications and gain a more comprehensive understanding of the relationship between RA and depression.

Methods: Two-sample MR was used to evaluate the causal effect of RA on the dose of depression medications. The aggregated data on RA originated from extensive genome-wide association studies (GWASs) of European descent (14,361 cases and 42,923 controls). The summary GWAS data for the dose of depression medications were derived from the FinnGen consortium (58,842 cases and 59,827 controls). Random effects inverse-variance weighted (IVW), MR-Egger regression, weighted median, and fixed effects IVW methods were used for the MR analysis. Random effects IVW was the primary method. The heterogeneity of the MR results was detected using the IVW Cochran's Q test. The pleiotropy of the MR results was detected using MR-Egger regression and the MR pleiotropy residual sum and outlier (MR-PRESSO) test. Finally, a leave-one-out analysis was performed to determine whether the MR results were affected by a specific single-nucleotide polymorphism (SNP).

Results: The primary method, random effects IVW, revealed that genetically predicted RA had a positive causal association with the dose of depression medications (Beta, 0.035; 95% confidence interval (CI), 0.007-0.064; p = 0.015). The IVW Cochran's Q test results revealed no heterogeneity in the MR analysis (p > 0.05). The MR-Egger regression and MR-PRESSO tests revealed that there was no pleiotropy in our MR analysis. The leave-one-out analysis confirmed that a single SNP did not affect the MR results, indicating the study's robustness.

Conclusion: Using MR techniques, we discovered that having RA increases the dose of depression medications; however, the exact mechanisms and pathways still need to be further explored.

Keywords: Mendelian randomization; causal association; depression medications; genome-wide association study; rheumatoid arthritis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
An overview of the study design. SNP, single-nucleotide polymorphism.
Figure 2
Figure 2
The results of Mendelian randomization for the associations of genetically predicted rheumatoid arthritis and rheumatoid arthritis * (after removing outliers) with depression medications.
Figure 3
Figure 3
Association between genetically predicted rheumatoid arthritis and depression medications presented in (A) scatter plot, (B) funnel plot, (C) leave-one-out sensitivity analysis, and (D) forest plot.
Figure 4
Figure 4
Association between genetically predicted rheumatoid arthritis (after removing outliers) and depression medications presented in (A) scatter plot, (B) funnel plot, (C) leave-one-out sensitivity analysis, and (D) forest plot.
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