A study published in JAMA Neurology found associations between β-blocker use and delayed motor symptom onset in premanifest Huntington disease and slower symptom progression in early motor-manifest HD.

The observational study analyzed data from the Enroll-HD platform database. Premanifest Huntington disease (preHD) patients using β-blockers demonstrated a 34% lower annualized risk of receiving a motor diagnosis compared with matched nonusers.

"Overall, we have demonstrated that the use of β-blockers was associated with a significantly lower annualized risk of receiving a clinical diagnosis of HD in participants with preHD; furthermore, β-blockers were associated with a slower rate of worsening of clinical symptoms of HD among participants with motor-manifest HD (mmHD)," the researchers wrote.

In patients with mmHD, β-blocker users showed differences in progression rates compared with nonusers for total motor score, total functional capacity score, and symbol digit modalities test.

The study included 174 preHD β-blocker users matched with 174 nonusers, and 149 mmHD β-blocker users matched with 149 nonusers. The researchers used propensity score matching to control for variables.

Among preHD patients, propranolol, metoprolol, and bisoprolol were the most frequently used β-blockers. In mmHD patients, metoprolol was most common, followed by bisoprolol and propranolol. Hypertension was the primary indication for β-blocker use, accounting for 44.8% of preHD cases and 57.7% of mmHD cases.

Post hoc analyses examined selective versus nonselective β-blockers, with data showing differences in effectiveness between the types.

The researchers noted several limitations, including the study's observational nature and inability to determine causative mechanisms. The predominant use of lipophilic β-blockers (96.5% in preHD and 89.3% in mmHD) prevented comparison with hydrophilic agents. The study authors indicated additional research would be needed to understand the mechanisms behind these associations.