The following article is part of conference coverage from the 2022 American Academy of Neurology (AAN) Annual Meeting. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the 2022 AAN Annual Meeting.

 

Exposure to β2-adrenoreceptor (β2AR) agonists, particularly ultra-long-acting β2AR agonists, may be associated with a reduced risk of developing Parkinson disease (PD), according to study findings presented at the 2022 American Academy of Neurology (AAN) Annual Meeting, held from April 2 to April 7 in Seattle, Washington, and virtually from April 24-26, 2022.


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Salbutamol, a selective β2AR agonist, is utilized for obstructive airway diseases. Previous research has found salbutamol was associated with a decreased risk of developing PD. The objective of the current study was to further explore this association and consider different subtypes of β2AR agonists with improved PD cases and a greater follow-up period.

In the study, a small team of researchers from Norway and the United States evaluated the association between exposure to β2AR agonists and PD risk in a large population. The researchers used Cox regression, with age as the timescale and β2AR agonist use as a time-dependent exposure variable.

They considered separately groups of short-acting β agonists (SABA), long-acting β agonists (LABA), and ultra-long-acting β agonists (ultra-LABA) as exposure variables. Analyses were adjusted for educational level and use of nicotine replacement therapy (NRT). According to the researchers, education level is “strongly associated with smoking” in Norway.

In addition, the researchers performed a sensitivity analysis which excluded individuals with chronic obstructive pulmonary disease (COPD) as a treatment indication.

During the follow-up period, the researchers identified a total of 11,075 incident cases of PD. A “markedly lower” risk for PD was associated with use of SABA (hazard ratio [HR], 0.85; 95% CI, 0.80-0.90), LABA (HR, 0.87; 95% CI, 0.82-0.92), and ultra-LABA (HR, 0.59; 95% CI, 0.49-0.90).

The researchers noted that only small changes were found in the estimates following adjustment for educational level and NRT. While the estimates were attenuated after excluding individuals with COPD, they reportedly remained strong for ultra-LABA use (HR, 0.65; 95% CI, 0.29-1.14).

The researchers wrote that “this suggests that smoking, a prominent confounding variable, cannot fully explain the associations between β2AR agonists and PD risk.”

Reference

Tuominen J, Bjørnevik K, Romanowska J, et al. Selective β2-adrenoreceptor agonists and long-term Parkinson’s disease risk. Presented at: the 2022 AAN Annual Meeting; April 2-7, 2022; Seattle, Washington; April 24-26, 2022; Virtual Meeting. Abstract S12.010.