{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:02:56Z","timestamp":1790834576279,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T00:00:00Z","timestamp":1540857600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000864","name":"Michael J. Fox Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000864","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["K24 ES017765"],"award-info":[{"award-number":["K24 ES017765"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01 NS099129"],"award-info":[{"award-number":["R01 NS099129"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006309","name":"American Parkinson Disease Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006309","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>A recent study observed a 2\u2010fold greater risk of Parkinson disease (PD) in relation to the \u03b22\u2010adrenoreceptor antagonist propranolol and a markedly lower risk of PD for the \u03b22\u2010adrenoreceptor agonist salbutamol. We examined whether confounding by clinical indication for these medications, that is, tremor and smoking\u2010related pulmonary conditions, explained these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a large, population\u2010based case\u2013control study of United States Medicare beneficiaries in 2009 with diagnosis codes, procedure codes, and prescription data (48,295 incident PD cases, 52,324 controls), we examined the risk of PD in relation to use of selected \u03b2 antagonists (propranolol, carvedilol, metoprolol), the \u03b22 agonist salbutamol, and other medications used for the same clinical indications (primidone, inhaled corticosteroids). We adjusted for demographics, smoking, and overall use of medical care. We then examined the effect of also adjusting for clinical indication and applying medication exposure lagging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Propranolol appeared to increase PD risk (odds ratio [OR]\u2009=\u20093.62, 95% confidence interval [CI]\u2009=\u20093.31\u20133.96). When we adjusted for tremor or abnormal involuntary movement prior to the PD diagnosis\/reference date and lagged propranolol exposure, the association was 0.97 (95% CI\u2009=\u20090.80\u20131.18). Primidone, also used for tremor, was similarly sensitive to this adjustment and lagging. \u03b2 Antagonists not indicated for tremor appeared to reduce PD risk (carvedilol: OR\u2009=\u20090.77, 95% CI\u2009=\u20090.73\u20130.81; metoprolol: OR\u2009=\u20090.94, 95% CI\u2009=\u20090.91\u20130.97) and were insensitive to adjustment for indications and lagging. Neither salbutamol nor inhaled corticosteroids were consistently associated with PD risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>\u03b22\u2010adrenoreceptor agonists and antagonists do not appear to alter PD risk. Ann Neurol 2018;84:691\u2013701<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.25341","type":"journal-article","created":{"date-parts":[[2018,9,17]],"date-time":"2018-09-17T22:11:10Z","timestamp":1537222270000},"page":"683-693","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["\u03b22\u2010adrenoreceptor medications and risk of Parkinson disease"],"prefix":"10.1002","volume":"84","author":[{"given":"Susan","family":"Searles Nielsen","sequence":"first","affiliation":[{"name":"Department of Neurology Washington University School of Medicine  St Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine  St Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Camacho\u2010Soto","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine  St Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison W.","family":"Willis","sequence":"additional","affiliation":[{"name":"Departments of Neurology and of Biostatistics, Epidemiology, and Informatics University of Pennsylvania Perelman School of Medicine  Philadelphia PA"},{"name":"Center for Pharmacoepidemiology Research and Training University of Pennsylvania Perelman School of Medicine  Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad A.","family":"Racette","sequence":"additional","affiliation":[{"name":"Department of Neurology Washington University School of Medicine  St Louis MO"},{"name":"School of Public Health, Faculty of Health Sciences University of the Witwatersrand  Parktown South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaf3934"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004536"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028013519591"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2013.12.001"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70322-7"},{"key":"e_1_2_8_7_1","volume-title":"International nonproprietary names (INN) for pharmaceutical substances: lists 1\u2010105 of proposed INN and lists 1\u201066 of recommended INN: cumulative list no. 14","year":"2011"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.05.026"},{"key":"e_1_2_8_9_1","volume-title":"WHOCC ATC\/DDD Index","year":"2018"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005678"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3953"},{"key":"e_1_2_8_12_1","unstructured":"Centers for Disease Control and Prevention.BRFSS 2009 survey data and documentation. 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