Am J Epidemiol. 2020 Aug 1;189(8):801-810. doi: 10.1093/aje/kwaa012.
A recent study found a decreased risk of Parkinson disease (PD) associated with the β2 adrenergic agonist (β2-agonist) salbutamol. However, other mechanisms might explain this apparent association. Using the UK Clinical Practice Research Datalink, we formed a cohort of 2,430,884 patients aged 50 years or older between 1995 and 2016. During follow-up, 8,604 cases of PD were identified and matched to 86,040 controls on sex, age, date of cohort entry, and duration of follow-up, after applying a 1-year latency time window. Incidence rate ratios of PD associated with use of β2-agonists were estimated using conditional logistic regression. Ever-use of β2-agonists was associated with a 17% decreased rate of PD (rate ratio = 0.83, 95% confidence interval: 0.75, 0.91) compared with no use. However, this association was limited to early short-term use and was no longer observed after more than 2 years of cumulative duration of use (rate ratio = 0.97, 95% confidence interval: 0.80, 1.17). A similar pattern was observed when stratifying by time since first β2-agonist prescription and by duration of follow-up. The apparent association of β2-agonists with a decreased risk of PD is likely the result of reverse causality rather than a biological effect of these drugs on the risk of PD.
最近的一项研究发现，β2 肾上腺素能激动剂（β2-agonist）沙丁胺醇与帕金森病（PD）的风险降低有关。然而，其他机制可能解释了这种明显的关联。我们使用英国临床实践研究数据链接，在 1995 年至 2016 年间形成了一个由 2430884 名年龄在 50 岁或以上的患者组成的队列。在随访期间，确定了 8604 例 PD 病例，并根据性别、年龄、队列进入日期和随访时间，在应用 1 年潜伏期窗口后，将其与 86040 名对照匹配。使用条件逻辑回归估计与β2-激动剂使用相关的 PD 发生率比值。与未使用相比，β2-激动剂的既往使用与 PD 发生率降低 17%相关（发生率比=0.83，95%置信区间：0.75，0.91）。然而，这种关联仅限于早期短期使用，并且在使用累积时间超过 2 年后不再观察到（发生率比=0.97，95%置信区间：0.80，1.17）。当按首次β2-激动剂处方后时间和随访时间分层时，观察到类似的模式。β2-激动剂与 PD 风险降低之间的明显关联可能是反向因果关系的结果，而不是这些药物对 PD 风险的生物学影响。
