A recent study observed a two-fold greater risk of Parkinson disease (PD) in relation to the β2-adrenoreceptor antagonist propranolol and a markedly lower risk of PD for the β2-adrenoreceptor agonist salbutamol. We examined whether confounding by clinical indication for these medications, i.e. tremor and smoking-related pulmonary conditions, explained these associations.
In a large, population-based case-control study of United States Medicare beneficiaries in 2009 with diagnosis codes, procedure codes, and prescription data (48,295 incident PD cases, 52,324 controls), we examined the risk of PD in relation to use of selected β antagonists (propranolol, carvedilol, metoprolol), the β2 agonist salbutamol, and other medications used for the same clinical indications (primidone, inhaled corticosteroids). We adjusted for demographics, smoking, and overall use of medical care. We then examined the effect of also adjusting for clinical indication and applying medication exposure lagging.
Propranolol appeared to increase PD risk (odds ratio [OR]=3.62, 95% confidence interval [CI] 3.31-3.96). When we adjusted for tremor or abnormal involuntary movement prior to the PD diagnosis/reference date and lagged propranolol exposure, the association was 0.97 (95% CI 0.80-1.18). Primidone, also used for tremor, was similarly sensitive to this adjustment and lagging. β antagonists not indicated for tremor appeared to reduce PD risk (carvedilol OR=0.77, 95% CI 0.73-0.81; metoprolol OR=0.94, 95% CI 0.91-0.97) and were insensitive to adjustment for indications and lagging. Neither salbutamol nor inhaled corticosteroids were consistently associated with PD risk.
β2-adrenoreceptor agonists and antagonists do not appear to alter PD risk. This article is protected by copyright. All rights reserved.
Pharmacology, Toxicology and Pharmaceutical Science
7
7%
Biochemistry, Genetics and Molecular Biology
3
3%
Mathematics
2
2%
Other
8
9%
Unknown
48
51%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 December 2020.
All research outputs
#21,739,885
of 33,141,706 outputs
Outputs from Annals of Neurology
#5,812
of 6,725 outputs
Outputs of similar age
#233,554
of 385,572 outputs
Outputs of similar age from Annals of Neurology
#44
of 50 outputs
Altmetric has tracked 33,141,706 research outputs across all sources so far. This one is in the 33rd percentile – i.e., 33% of other outputs scored the same or lower than it.
So far Altmetric has tracked 6,725 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.4. This one is in the 13th percentile – i.e., 13% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 385,572 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 38th percentile – i.e., 38% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 50 others from the same source and published within six weeks on either side of this one. This one is in the 12th percentile – i.e., 12% of its contemporaries scored the same or lower than it.
