Beta-blocker Prescription Associated with Reduced Consultation for Knee OA

Sarfaroj Khan 

Disclosures

March 17, 2021

Takeaway

  • Beta-blocker prescription was associated with reduced primary care consultation for knee osteoarthritis (OA), knee pain and hip pain.

  • Atenolol could be considered for patients with OA and cardiovascular co-morbidities, while propranolol may be suitable for patients with OA and co-morbid anxiety.

Why this matters

  • Findings suggest that commonly used beta-blockers have analgesic properties for musculoskeletal pain.

  • A confirmatory randomised controlled trial is needed before clinical practice is changed.

Study design

  • This study included 223,436 participants (age, ≥40 years) from the UK Clinical Practice Research Datalink (CPRD; 1990-2017).

  • 111,718 beta-blockers–exposed participants were (1:1) propensity score matched to unexposed participants.

  • Main outcome: first primary care consultation for knee OA, hip OA, knee pain and hip pain.

  • Funding: National Institute for Health Research.

Key results

  • Beta-blocker prescription was associated with reduced cumulative risk of primary care consultations for (adjusted HR [aHR]; 95% CI):

    • knee OA (0.90; 0.83-0.98);

    • knee pain (0.88; 0.83-0.92); and

    • hip pain (0.85; 0.79-0.90).

  • Propranolol and atenolol were associated with a lower incidence of primary care consultations for (aHR; 95% CI):

    • knee OA (0.78; 0.63-0.97 and 0.91; 0.82-1.00, respectively); and

    • knee pain (0.78; 0.69-0.87 and 0.86; 0.81-0.91, respectively);

  • Beta-blockers were associated with reduced cumulative risk of primary care consultation for large-joint lower-limb OA and/or pain, defined as the earliest of knee OA, knee pain, hip OA or hip pain (aHR, 0.87; 95% CI, 0.84-0.90).

Limitations

  • Researchers could not undertake multiple imputations to account for missing smoking status and body mass index data because these were missing in 50.5% and 60.3% of participants, respectively.

 

Nakafero G, Grainge MJ, Valdes AM, Townsend N, Mallen C, Zhang W, Doherty M, Mamas M, Abhishek A. β-blocker prescription is associated with lower cumulative risk of knee osteoarthritis and knee pain consultations in primary care: a propensity score matched cohort study. Rheumatology (Oxford). 2021 Mar 12 [Epub ahead of print]. doi: 10.1093/rheumatology/keab234. PMID: 33710319.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....