Topical β-blockers for treatment of glaucoma and the risk of Parkinson’s disease

Background/Aims Reports have suggested that treatment with systemic β-adrenoceptor antagonists (β-blockers) may increase the risk of developing Parkinson’s disease (PD). The objective of this study was to assess the association between the use of topical β-blockers and PD. Methods A retrospective cohort study. All newly diagnosed glaucoma patients between 2000 and 2020 were recruited from the anonymised electronic medical records of a large healthcare provider. Patients were followed until December 2021 for the occurrence of PD. The patients were divided into two groups according to topical β-blocker use. Cox proportional-hazards models were used, and HRs with 95% CIs were calculated. Results The cohort included 13381 glaucoma patients, of whom 10075 used topical β-blockers (βB group) and 3306 did not (no-βB group). Demographic characteristics were similar between groups. Mean follow-up time and mean number of filled prescriptions for anti-glaucoma medication (total and annually) were significantly greater in the βB group (p<0.0001). During follow-up, 175 patients (1.31%) were diagnosed with PD, 145 in the βB group and 30 in the no-βB group. The HR for PD among topical β-blocker users compared with non-users was 1.16 (95% CI 0.78 to 1.72, p=0.47). Kaplan-Meier analysis showed no significant difference in PD-free survival between the groups (p=0.47). Conclusions Topical β-blocker use was not associated with an increased risk of PD. These findings suggest that topical β-blockers are a safe therapeutic option, even for patients at potential risk for PD.