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