Table 1.
β-adrenoreceptor Antagonists and Primidone in Relation to Parkinson Disease, by Medication Exposure Lagging and Adjustment for Tremor
| Age-sex-race-adjusted OR (95% CI)a |
||||
|---|---|---|---|---|
| No lag | 6 months | 12 months | 18 months | |
| Cases, nb | 48,295 | 46,430 | 43,095 | 19,122 |
| Controls, nb | 52,324 | 50,518 | 46,341 | 21,286 |
| Propranolol | ||||
| Cases, % | 4.4 | 3.6 | 2.9 | 2.4 |
| Controls, % | 1.3 | 1.3 | 1.2 | 1.1 |
| Adjusted for age/sex/race onlya | 3.54 (3.24–3.86) | 2.97 (2.70–3.26) | 2.63 (2.37–2.92) | 2.16 (1.84–2.54) |
| Basic modelc | 3.62 (3.31–3.96) | 3.04 (2.76–3.34) | 2.70 (2.44–3.00) | 2.24 (1.90–2.64) |
| Also adjusted for tremorc,d | 1.41 (1.27–1.56) | 1.20 (1.07–1.34) | 1.11 (0.98–1.25) | 0.97 (0.80–1.18) |
| Carvedilol | ||||
| Cases, % | 6.9 | 5.8 | 4.7 | 4.1 |
| Controls, % | 6.1 | 5.3 | 4.4 | 3.6 |
| Adjusted for age/sex/race onlya | 1.10 (1.04–1.16) | 1.06 (1.00–1.12) | 1.04 (0.97–1.11) | 1.07 (0.97–1.19) |
| Basic modelc | 0.77 (0.73–0.81) | 0.79 (0.74–0.83) | 0.79 (0.74–0.84) | 0.82 (0.74–0.92) |
| Also adjusted for tremorc,d | 0.83 (0.78–0.87) | 0.84 (0.79–0.90) | 0.85 (0.79–0.91) | 0.88 (0.78–0.98) |
| Metoprolol | ||||
| Cases, % | 26.3 | 24.0 | 20.8 | 19.0 |
| Controls, % | 22.6 | 21.2 | 19.1 | 17.8 |
| Adjusted for age/sex/race onlya | 1.17 (1.14–1.21) | 1.12 (1.09–1.16) | 1.07 (1.03–1.10) | 1.05 (1.00–1.11) |
| Basic modelc | 0.94 (0.91–0.97) | 0.95 (0.92–0.98) | 0.93 (0.90–0.96) | 0.93 (0.88–0.98) |
| Also adjusted for tremorc,d | 0.94 (0.91–0.97) | 0.95 (0.92–0.99) | 0.94 (0.91–0.98) | 0.94 (0.89–0.99) |
| Primidone | ||||
| Cases, % | 3.9 | 2.9 | 2.2 | 1.7 |
| Controls, % | 0.4 | 0.4 | 0.3 | 0.2 |
| Adjusted for age/sex/race onlya | 10.8 (9.32–12.5) | 8.92 (7.61–10.5) | 7.84 (6.54–9.40) | 7.21 (5.35–9.73) |
| Basic modelc | 9.68 (8.35–11.2) | 8.06 (6.87–9.46) | 7.10 (5.91–8.52) | 6.72 (4.97–9.09) |
| Also adjusted for tremorc,d | 1.76 (1.48–2.08) | 1.27 (1.06–1.53) | 0.99 (0.80–1.23) | 0.96 (0.68–1.36) |
Adjusted for age (two linear splines), sex, and race (and ethnicity, in 7 categories).
Excludes cases and controls from the original study2 who had no Part D coverage in 2008–2009 or with Part D coverage but no medication fills in the respective time period prior to diagnosis/reference.
Adjusted for age, sex, race, probability of ever smoking (continuous, 0 to 1), oxygen use,17 use of nicotine and/or varenicline, and overall use of medical care (number of unique ICD-9 codes, continuous)2 in 2004–2009 prior to diagnosis/reference or the specified number of months prior if lagged.
Also adjusted for presence of tremor (Supplemental Table 1) prior to PD diagnosis/control reference.
PD=Parkinson disease; ICD-9=International Classification of Disease, Ninth Revision, Clinical Modification; OR=odds ratio; CI=confidence interval