LAUSR

Background: Patients with chronic obstructive pulmonary disease (COPD) have an elevated risk of Parkinson’s disease (PD) whereas β2-adrenoreceptor agonists, the cornerstone of COPD therapy, are associated with lower risk of PD. Objective: To examine the association between β2-agonist use and PD risk in patients with COPD. Methods: We performed a nested case-control study based on the health administrative data of British Columbia, Canada (1997–2015). Individuals with ≥40 years of age were included if they satisfied a validated case definition of COPD. Within the COPD cohort, we identified a PD sub-cohort in which patients have incurred ≥1 PD-related healthcare encounter and then filled ≥1 anti-PD medication within 90 days after the initial PD diagnosis. Each PD patient was then matched to five COPD patients without PD based on the latency period between the first COPD diagnosis and the first dispensation of anti-PD medication (≥4 years), as well as age, sex, calendar year and COPD severity. We used conditional logistic regression to estimate rate ratios to β2-agonists adjusting for potential confounder. Results: From 242,641 COPD patients, the final analysis included 662 patients in the PD sub-cohort and 3310 in the non-PD sub-cohorts (a 1:5 ratio). Therapeutic use of β2-agonists did not significantly affect the subsequent two-year risk of PD (versus no use, hazard ratios: regular use, 0.93 [95% CI: 0.76-1.16, p=0.53], irregular use, 0.96 [95% CI: 0.75–1.22, p=0.72]). Conclusion: In a population-based sample of surviving COPD patients β2-agonists users had a similar risk of developing PD as compared to the non-users.