| アブストラクト | OBJECTIVES: To examine the association between beta-blocker prescription and first primary-care consultation for knee OA, hip OA, knee pain and hip pain. METHODS: Data source: Clinical Practice Research Datalink. Participants aged >/=40 years in receipt of new oral beta-blocker prescriptions were propensity score (PS) matched to an unexposed control. Cox proportional hazard ratios (HRs) and 95% CIs were calculated, and adjusted for non-osteoporotic fractures, number of primary-care consultations for knee or hip injury, and, the number of primary-care consultations, out-patient referrals and hospitalizations in the 12 months preceding cohort entry. Analysis was stratified according to beta-blocker class and for commonly prescribed drugs. P < 0.05 was considered statistically significant. RESULTS: A total of 111 718 beta-blocker-exposed participants were 1:1 PS matched to unexposed controls. beta-blocker prescription was associated with reduced cumulative risk of knee OA, knee pain, and hip pain consultations [with a HR (95% CI) of 0.90 (0.83, 0.98), 0.88 (0.83, 0.92) and 0.85 (0.79, 0.90), respectively]. Propranolol and atenolol were associated with a lower incidence of knee OA and knee pain consultations with a HR of between 0.78 and 0.91. beta-blockers were associated with reduced incidence of consultation for large-joint lower-limb OA/pain as a composite outcome, defined as the earliest of knee OA, knee pain, hip OA or a hip pain consultation [with a HR (95% CI) of 0.87 (0.84, 0.90)]. CONCLUSION: Commonly used beta-blockers have analgesic properties for musculoskeletal pain. Atenolol might be a therapeutic option for OA and cardiovascular co-morbidities in which beta-blockers are indicated, while propranolol may be suitable for people with co-morbid anxiety. A confirmatory randomized controlled trial is needed before clinical practice is changed. |
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| ジャーナル名 | Rheumatology (Oxford, England) |
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| 投稿日 | 2021/3/13 |
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| 投稿者 | Nakafero, Georgina; Grainge, Matthew J; Valdes, Ana M; Townsend, Nick; D Mallen, Christian; Zhang, Weiya; Doherty, Michael; Mamas, Mamas; Abhishek, Abhishek |
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| 組織名 | Academic Rheumatology.;Epidemiology and Public Health, School of Medicine, University of Nottingham.;Nottingham NIHR-BRC, Nottingham.;Public Health Epidemiology, Department for Health, University of Bath, Bath.;School of Medicine, Keele University, Keele.;Department of Cardiology, Keele University, Keele, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33710319/ |
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