Psoriasis risk after beta‐blocker exposure: Description of a pharmacovigilance signal

Abstract

Aim We aimed to investigate French pharmacovigilance data. The objective was to characterize psoriatic conditions that occurred after beta‐blocker (BB) exposure and bring to light a possible pharmacovigilance signal. Methods Spontaneous reports of psoriatic conditions recorded in the French National Pharmacovigilance Database (FPVD) between 1985 and 2019 were extracted. We performed a retrospective, descriptive analysis of reports linked to BB exposure. Association between psoriasis risk and BB exposure was assessed using a case/noncase study. Results Two hundred and twenty‐five reports of psoriatic conditions after BB exposure were recorded in the FPVD during the study period. Both cardioselective and noncardioselective, topical and systemic BBs are involved. Therapeutic indication of BB was mainly hypertension. Mean time to onset was 5 months and outcome was favourable in 68% after BB discontinuation. These features were concordant with those of literature reports. The reporting odds ratio (ROR) was 8.95 (95% confidence interval 7.75‐10.33). Conclusion We highlighted a statistically significant disproportionality which constitutes a pharmacovigilance signal. Psoriasis risk with BBs is a class effect. Increasing surveillance during the first year of BB exposure is needed.

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension

“…In patients with psoriatic arthritis, BP should be lowered according to the general antihypertensive treatment recommendations, preferentially with RAS inhibitors and CCBs. BBs may trigger or worsen psoriasis and should be avoided if possible or carefully used in the presence of compelling indications [1545] (Table 16). Glucose control should be considered in patients with hypertension and psoriatic arthritis [1546].…”

Histamine H2 receptor antagonist exhibited comparable all-cause mortality-decreasing effect as β-blockers in critically ill patients with heart failure: a cohort study

“…In the comparative analyses, we provided novel evidence that H2RAs exposure was associated with similar decreased all-cause mortality as β-blockers exposure did, which demonstrated that H2RAs had parallel anti-HF effect with β-blockers, especially for medium- and long-term outcomes, and strongly indicated that H2RAs might be, at least in part, an ideal kind of substitution to β-blockers in the treatment of HF because of their common pharmacological effects (i.e., down-regulation of cAMP and negative chronotropic and inotropic effects). It is noteworthy that, although β-blockers are one of the key recommended treatments for HF currently, the intrinsic disadvantages of this kind of drugs inevitably lead to relatively low drug adherence and even a series of adverse events in clinical practice ( Garcia et al, 2021 ; Azzouz et al, 2022 ). In this regard, H2RAs may have certain advantages over β-blockers.…”