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Propranolol Reduces Risk of Knee or Hip Replacement Due to Osteoarthritis: a Propensity Score Matched Cohort Study-using Data From the Clinical Practice Research Datalink.

Mamas; Mallen

Propranolol Reduces Risk of Knee or Hip Replacement Due to Osteoarthritis: a Propensity Score Matched Cohort Study-using Data From the Clinical Practice Research Datalink. Thumbnail


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Abstract

<h4>Objectives: </h4> To examine the association between ß -blocker prescription and knee or hip total joint replacement (TJR) in a UK primary-care population with incident knee or hip osteoarthritis (OA). <h4>Methods: </h4> Cohort study using data from the Clinical Practice Research Datalink. Participants aged =40 years with incident knee or hip OA, exposed to ß -blockers after OA diagnosis (new-user design), were matched to one control for age, sex, OA location and propensity score (PS) for ß -blocker prescription. Cox-proportional hazard ratios (HRs) and 95% confidence intervals (CI) were calculated. The analyses were adjusted for factors that influence health-seeking behaviour, progression of OA, and stratified according to ß -blocker classification. Data analysis was conducted using Stata. <h4>Results: </h4> Data for 6,970 PS-matched ß -blocker exposed and unexposed participants were included. Any ß -blocker prescription was not associated with knee or hip TJR (aHR 1.11; 95% CI 0.98 – 1.25). However, prescription of lipophilic non-selective ß-blockers having membrane stabilising effects associated with reduced risk of knee or hip TJR (aHR 0.69; 95% CI 0.52 – 0.93). Of these, there was a protective effect for propranolol (aHR 0.71; 95% CI 0.53 – 0.95), the commonest prescribed drug in this class. The number needed to treat (95% CI) with propranolol for two years in order to prevent one TJR was 32 (23-52). <h4>Conclusion: </h4> Propranolol, a non-selective ß-blocker, reduces the risk of knee and hip TJR. This is consistent with its analgesic effects in other conditions and a randomised controlled trial is required to further evaluate its analgesic potential and safety in OA.

Acceptance Date Jul 7, 2021
Publication Date Jul 7, 2021
Journal Research Square
Publisher Research Square Company
DOI https://doi.org/10.21203/rs.3.rs-670522/v1
Publisher URL https://www.researchsquare.com/article/rs-670522/v1

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