Respiratory Evaluation Sciences Program, Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, BC, Canada.
Pharmacotherapy. 2020 May;40(5):408-415. doi: 10.1002/phar.2383. Epub 2020 Apr 1.
Multiple studies have investigated the role of β -adrenoreceptor agonists on the risk of Parkinson's disease (PD). However, whether β -agonist use is associated with the risk of PD in patients with chronic obstructive pulmonary disease (COPD) has not been examined to date.
To examine the association between use of β -agonist and the risk of PD in patients with COPD.
A case-control study nested within a cohort of patients with COPD using the British Columbia health administrative databases from 1997 to 2015 was performed. Among a cohort of patients with COPD, all cases of PD were identified, and matched each case to up to five controls by age and calendar time. The use of β -agonists was assessed between the third and fourth year preceding the date of PD diagnosis, followed by additional two years of grace period (between the first and second year preceding PD incidence) to control for PD latency. The use of β -agonists was categorized into three levels: regular use (≥ 1 dispensation for every 6 months), irregular use (dispensation in one to three 6-month periods), and no use. A conditional logistic regression model was used to estimate the rate ratio of PD according to β2-agonist use, rigorously controlling for confounding variables.
Among 242,218 COPD patients, 732 PD cases and 3660 controls were identified. Use of β -agonists did not significantly affect the subsequent risk of PD (vs no use, adjusted rate ratios: regular use, 1.14 [95% CI: 0.93, 1.40, p=0.21], irregular use, 1.15 [95% CI: 0.92, 1.45, p=0.22]). Results remained consistent with competing risk sensitivity analysis.
Use of β -agonists does not appear to affect the risk of PD in a real-world COPD population.
多项研究已经探讨了β-肾上腺素受体激动剂对帕金森病（PD）风险的作用。然而，迄今为止，尚未研究慢性阻塞性肺疾病（COPD）患者β-激动剂的使用是否与 PD 的风险相关。
研究 COPD 患者中β-激动剂的使用与 PD 风险之间的关系。
使用不列颠哥伦比亚省从 1997 年到 2015 年的健康管理数据库，进行了一项嵌套在 COPD 患者队列中的病例对照研究。在 COPD 患者队列中，确定了所有 PD 病例，并按年龄和日历时间与每个病例匹配了最多 5 个对照。在 PD 诊断日期前的第三和第四年评估了β-激动剂的使用情况，随后又增加了两年的宽限期（PD 发病前的第一和第二年）以控制 PD 的潜伏期。β-激动剂的使用分为三个水平：常规使用（每 6 个月至少有 1 次配药）、不规则使用（在一个至三个 6 个月的时间段内配药）和不使用。使用条件逻辑回归模型来估计根据β2-激动剂使用情况的 PD 发生率比，严格控制混杂变量。
在 242218 例 COPD 患者中，确定了 732 例 PD 病例和 3660 例对照。β-激动剂的使用并未显著影响 PD 的后续风险（与不使用相比，调整后的发生率比：常规使用，1.14[95%CI：0.93，1.40，p=0.21]；不规则使用，1.15[95%CI：0.92，1.45，p=0.22]）。敏感性分析和竞争风险分析结果一致。
在真实世界的 COPD 人群中，β-激动剂的使用似乎不会影响 PD 的风险。
