TY - JOUR
T1 - Beta-adrenergic drugs and risk of Parkinson's disease
T2 - A systematic review and meta-analysis
AU - Singh, Ambrish
AU - Hussain, Salman
AU - Akkala, Sreelatha
AU - Klugarova, Jitka
AU - Pokorna, Andrea
AU - Klugar, Miroslav
AU - Walters, E. Haydn
AU - Hopper, Ingrid
AU - Campbell, Julie A.
AU - Taylor, Bruce
AU - Antony, Benny
N1 - Funding Information:
AS is supported by the International Graduate Research Scholarship , University of Tasmania. BA was supported by the National Health and Medical Research Council of Australia Fellowship ( 2017–20 ). SH was supported from Operational Programme Research, Development and Education –Project, Postdoc2MUNI “(No. CZ.02.2.69/0.0/0.0/18_053/0016952 )”; Miloslav Klugar, and Jitka Klugarová were supported by the INTER-EXCELLENCE grant number LTC20031 — “Towards an International Network for Evidence-based Research in Clinical Health Research in the Czech Republic.”
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/9
Y1 - 2022/9
N2 - Background: Parkinson's Disease (PD) is a neurodegenerative disorder manifested by rest tremor, rigidity, bradykinesia, and postural instability. Recent pharmaco-epidemiological studies evaluating beta-adrenergic drug use and risk of PD have reported conflicting findings. Objectives: This systematic review and meta-analyses evaluate the association between beta-adrenergic (agonists and antagonists) drugs’ use and PD. Methods: An electronic literature search of eight databases was performed from inception to July 2021 to identify pharmaco-epidemiological studies (case-control and cohort) reporting the risk of PD in beta-adrenergic users compared to non-users. We used the generic inverse variance method and RevMan (5.3.5) to estimate pooled adjusted risk ratios (aRRs) of PD using a random-effects model. Results: Of 3168 records, 15 studies (10 case-control; five cohort) with 6508,877 participants, including 87,011 PD cases, were included. In the pooled analysis (n = 10) including any beta-antagonist users, compared with non-users, the aRR for PD was 1.19 (CI: 1.05,1.35); for any beta-agonist users (n = 8) aRR for PD was 0.87 (CI: 0.78,0.97). Propranolol users had a significantly increased risk of PD (aRR:1.91; CI:1.20,3.06), whereas salbutamol use was associated with reduced risk of PD (aRR:0.95; CI:0.92,0.99). Significant heterogeneity (I2 >87%) was observed, but the majority (n = 13) of the studies were of high quality, based on the JBI tool. Conclusions: Beta-antagonist use was associated with a modestly increased risk of PD, whereas beta-agonist use was associated with a modest decreased risk of PD. Future epidemiological studies should address the issues of protopathic bias and indirect association using appropriate epidemiological methods.
AB - Background: Parkinson's Disease (PD) is a neurodegenerative disorder manifested by rest tremor, rigidity, bradykinesia, and postural instability. Recent pharmaco-epidemiological studies evaluating beta-adrenergic drug use and risk of PD have reported conflicting findings. Objectives: This systematic review and meta-analyses evaluate the association between beta-adrenergic (agonists and antagonists) drugs’ use and PD. Methods: An electronic literature search of eight databases was performed from inception to July 2021 to identify pharmaco-epidemiological studies (case-control and cohort) reporting the risk of PD in beta-adrenergic users compared to non-users. We used the generic inverse variance method and RevMan (5.3.5) to estimate pooled adjusted risk ratios (aRRs) of PD using a random-effects model. Results: Of 3168 records, 15 studies (10 case-control; five cohort) with 6508,877 participants, including 87,011 PD cases, were included. In the pooled analysis (n = 10) including any beta-antagonist users, compared with non-users, the aRR for PD was 1.19 (CI: 1.05,1.35); for any beta-agonist users (n = 8) aRR for PD was 0.87 (CI: 0.78,0.97). Propranolol users had a significantly increased risk of PD (aRR:1.91; CI:1.20,3.06), whereas salbutamol use was associated with reduced risk of PD (aRR:0.95; CI:0.92,0.99). Significant heterogeneity (I2 >87%) was observed, but the majority (n = 13) of the studies were of high quality, based on the JBI tool. Conclusions: Beta-antagonist use was associated with a modestly increased risk of PD, whereas beta-agonist use was associated with a modest decreased risk of PD. Future epidemiological studies should address the issues of protopathic bias and indirect association using appropriate epidemiological methods.
KW - Beta-adrenoceptors
KW - Beta-agonist
KW - Beta-antagonist
KW - Beta-blockers
KW - Parkinson's disease
KW - Propranolol
KW - Salbutamol
UR - http://www.scopus.com/inward/record.url?scp=85133352138&partnerID=8YFLogxK
U2 - 10.1016/j.arr.2022.101670
DO - 10.1016/j.arr.2022.101670
M3 - Review Article
C2 - 35718329
AN - SCOPUS:85133352138
SN - 1568-1637
VL - 80
JO - Ageing Research Reviews
JF - Ageing Research Reviews
M1 - 101670
ER -