Beta-Blockers Show Promise in Curbing HD Progression

TOPLINE:

Beta-blocker use is associated with a 34% reduction of onset in premanifest Huntington disease (preHD) and slower progression in early motor-manifest Huntington disease (mmHD), new research shows. 

METHODOLOGY:

• In this longitudinal multicenter study, 174 beta-blocker users with preHD (mean age, 46.4 years; 66% women) were matched with 174 nonusers (mean age, 48 years; 66% women).
• Researchers also assessed 149 beta-blocker users with mmHD (mean age, 59 years; 58% men) who were matched with 149 nonusers (mean age, 59 years; 61% men).
• Data were obtained from the Enroll-HD platform database (initiated in September 2011) for participants with uninterrupted beta-blocker use for more than 1 year.
• Primary outcomes included risk for motor diagnosis for preHD and progression rates of total motor score, total functional capacity score, and symbol digit modalities test score for mmHD.

TAKEAWAY:

• Propranolol was the most frequently used beta-blocker (n = 59), followed by metoprolol (n = 56), bisoprolol (n = 36), and nebivolol (n = 9).
• Among participants with preHD, beta-blocker users had a significantly lower annualized hazard of receiving a motor diagnosis compared with nonusers (hazard ratio, 0.66; P = .02).
• Among participants with mmHD, beta-blocker users showed slower mean annualized worsening of total motor score (mean difference [MD], -0.45; 95% CI, -0.85 to -0.06) and total functional capacity score (MD, 0.10; 95% CI, 0.02-0.18) and reduced decline scores on the symbol digit modalities test (MD, 0.33; 95% CI, 0.10-0.56) than nonusers.
• No significant differences in anxiety scores were found between beta-blocker users and nonusers with preHD, nor did the rate of progression of anxiety symptoms differ between beta-blocker users and nonusers with mmHD.

IN PRACTICE:

“We have demonstrated that the use of beta-blockers was associated with a significantly lower annualized risk of receiving a clinical diagnosis of HD in participants with preHD; furthermore, beta-blockers were associated with a slower rate of worsening of clinical symptoms of HD among participants with mmHD,” the investigators wrote.

SOURCE:

The study was led by Jordan L. Schultz, PharmD, Carver College of Medicine at the University of Iowa, Iowa City, Iowa. It was published online on December 2 in JAMA Neurology.

LIMITATIONS: 

All results represented associations rather than causative changes induced by beta-blockers. The researchers were unable to determine the potential mechanisms of the effects of beta-blockers in patients with HD. Additionally, the predominance of lipophilic beta-blocker users prevented a robust analysis comparing the effects of hydrophilic and lipophilic products. The study did not evaluate the dose-related effects of beta-blockers because of the wide range of medications used for various indications at differing daily doses. 

DISCLOSURES:

Three authors received salary and research support from the National Institute of Neurological Disorders and Stroke and other sources, with one also consulting for Novartis. The Enroll-HD study was funded by the CHDI Foundation.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.