title: Beta2-adrenergic agonist use and the risk of multiple sclerosis: a total population-based case-control study.
abstract: OBJECTIVE
  The aim of this study was to investigate whether the use of fenoterol, a beta2-adrenergic agonist, was associated with multiple sclerosis (MS) risk by conducting a total population-based case-control study in Taiwan.
  
  
  METHODS
  A total of 578 patients with newly diagnosed MS who had a severely disabling disease (SDD) certificate between January 1, 2002 and December 1, 2008 comprised the case group. These cases were compared with 2890 gender-, age-, residence-, and insurance premium-matched controls. Fenoterol use was analyzed using a conditional logistic regression model that controlled for asthma, chronic obstructive pulmonary disease (COPD), salbutamol and steroid use.
  
  
  RESULTS
  Compared with the group of people who did not use fenoterol, the adjusted odds ratios were 0.67 (95% confidence interval (CI) = 0.48-0.93, p = 0.016) for the group prescribed fenoterol below 2.25 cumulative defined daily dose (cDDD) and 0.49 (95% CI = 0.33-0.71, p < 0.001) for the group with a cumulative fenoterol use of more than 2.25 cDDD. The dose-response relationship was similar within the non-asthma patients. The associations were similar between males and females, but differences between age groups were observed.
  
  
  CONCLUSIONS
  The results of this study suggest that fenoterol use may reduce the risk of MS.
authors.affiliation: Neurological Institute, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan.
authors.forename: Ching-Piao
authors.initials: CP
authors.lastname: Tsai
authors.affiliation: Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan/Pingtung Hospital, Ministry of Health and Welfare, Taiwan.
authors.forename: Feng-Cheng
authors.initials: FC
authors.lastname: Lin
authors.affiliation: Kaohsiung Medical University, No. 100, Shih-Chuan 1st Rd., Sanmin District, Kaohsiung City 80708, Taiwan (R.O.C.) charles@kmu.edu.tw.
authors.forename: Charles Tzu-Chi
authors.initials: CT
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use*; D000328:Adult; D000420:Albuterol / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005280:Fenoterol / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D012306:Risk; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D005280:Fenoterol; D000420:Albuterol
keywords: Multiple sclerosis; case-control study; fenoterol