{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:00:29Z","timestamp":1790056829768,"version":"4.0.1"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008487","name":"Cure Parkinson's Trust","doi-asserted-by":"publisher","award":["LW02"],"award-info":[{"award-number":["LW02"]}],"id":[{"id":"10.13039\/100008487","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Ursodeoxycholic acid (UDCA) has shown mitochondrial and neuroprotective effects and has been proposed as a treatment for Parkinson's disease (PD). However, population\u2010level evidence on its effect on PD risk is lacking.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To compare the risk of incident PD among UDCA initiators versus matched non\u2010initiators within a hepatobiliary disease population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a cohort study emulating a target trial using UK primary care records linked to hospital and mortality data from 1990 to 2023. Eligible participants were adults aged 45\u201384\u2009years with hepatobiliary disease and no prior PD diagnosis or antiparkinsonian treatment. The intervention was UDCA initiation versus non\u2010initiation. We emulated 160 sequential trials across 3\u2010month age intervals and matched UDCA initiators 1:3 to non\u2010initiators using propensity scores. The main outcome was incident PD. Cumulative incidence was estimated using pooled logistic regression to derive risk differences (RDs) and risk ratios (RRs) with 95% confidence intervals (CIs). Secondary analyses used alternative outcome definitions, a 3\u2010year onset\u2010anchored definition, and a per\u2010protocol cumulative dose\u2013response analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n After matching 17,295 UDCA initiators to 51,885 non\u2010initiators, the 15\u2010year risk of PD was 1.70% versus 2.16% (RD \u22120.46 percentage points [95% CI \u22120.94 to \u22120.02]; RR 0.79 [95% CI 0.59 to 0.99]). The onset\u2010anchored analysis gave an RR of 0.69 (95% CI 0.48 to 0.90), and the per\u2010protocol dose\u2013response analysis an RR of 0.74 (95% CI 0.49 to 0.99).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n UDCA treatment is associated with a lower risk in PD. These findings require confirmation in randomized controlled trials. \u00a9 2026 The Author(s).\n Movement Disorders<\/jats:italic>\n published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mds.70535","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:07:50Z","timestamp":1790053670000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ursodeoxycholic Acid and Parkinson's Disease Risk: An Emulated Target Trial in\n UK<\/scp>\n Electronic Health Records"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7860-6262","authenticated-orcid":false,"given":"Chengsheng","family":"Ju","sequence":"first","affiliation":[{"name":"Research Department of Practice and Policy, University College London (UCL) School of Pharmacy London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-6680","authenticated-orcid":false,"given":"Anette","family":"Schrag","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences University College London (UCL) Institute of Neurology London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Carroll","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Newcastle University Newcastle\u2010upon\u2010Tyne United Kingdom"},{"name":"National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University Newcastle\u2010upon\u2010Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9418-7448","authenticated-orcid":false,"given":"Xi","family":"Xiong","sequence":"additional","affiliation":[{"name":"Research Department of Practice and Policy, University College London (UCL) School of Pharmacy London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3890-6206","authenticated-orcid":false,"given":"James","family":"Carpenter","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit Institute of Clinical Trials and Methodology, University College London (UCL) London UK"},{"name":"Department of Medical Statistics, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Population Health London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3149-0252","authenticated-orcid":false,"given":"Oliver","family":"Bandmann","sequence":"additional","affiliation":[{"name":"Sheffield Institute for Translational Neuroscience, School of Medicine and Population Health, University of Sheffield Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0752-1813","authenticated-orcid":false,"given":"Thomas","family":"Foltynie","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences University College London (UCL) Institute of Neurology London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8840-7267","authenticated-orcid":false,"given":"Li","family":"Wei","sequence":"additional","affiliation":[{"name":"Research Department of Practice and Policy, University College London (UCL) School of Pharmacy London United Kingdom"},{"name":"Centre for Medicines Optimisation Research and Education University College London (UCL) Hospitals National Health Service (NHS) Foundation Trust London 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