NEW RESEARCH has demonstrated that Beta blocker use is associated with delayed motor diagnosis in premanifest Huntington disease (preHD) and slower symptom progression in early motor-manifest Huntington disease (mmHD), highlighting potential therapeutic value.
Huntington disease (HD) is a progressive neurodegenerative disorder characterised by motor, cognitive, and psychiatric symptoms. Identifying treatments that slow its progression is critical for improving patient outcomes. This study investigated whether β-blockers, medications commonly used for cardiovascular conditions, could influence the timing of motor diagnosis onset and the progression of symptoms in preHD and mmHD.
The study analysed data from the Enroll-HD platform, a longitudinal database tracking patients with genetically confirmed HD. Two cohorts were examined: 174 preHD β-blocker users and 174 matched nonusers, as well as 149 mmHD β-blocker users and 149 matched nonusers. β-blocker users had at least one year of uninterrupted therapy. Statistical analyses revealed that preHD β-blocker users had a significantly lower annualised hazard of motor diagnosis compared to nonusers (hazard ratio, 0.66; 95% CI, 0.46-0.94; P = .02). Among mmHD patients, β-blocker users exhibited slower progression in motor (mean difference [MD], −0.45; q = 0.025), cognitive (MD for symbol digit modalities test, 0.33; q = 0.017), and functional capacity (MD, 0.10; q = 0.025) scores compared to nonusers.
The findings suggest that β-blockers could have a therapeutic role in HD, delaying motor onset and mitigating symptom progression in the early motor-manifest stage. These results are promising for clinical practice, particularly in incorporating β-blocker therapy for patients with preHD or mmHD. However, as this was an observational study, further randomised controlled trials are required to confirm the therapeutic efficacy and safety of β-blockers in HD. Exploring the underlying mechanisms by which β-blockers reduce symptom progression could also inform future therapeutic strategies.
Katrina Thornber, EMJ
Reference
Schultz JL et al. β-blocker use and delayed onset and progression of huntington disease. JAMA Neurol. 2024;DOI:10.1001/jamaneurol.2024.4108.
