Angiotensin Receptor Blockers Are Not Associated With Protective Benefits in Dupuytren's Disease

Dupuytren's disease (DD) is a progressive fibroproliferative disorder which is, in part, mediated by transforming growth factor beta 1 (TGF-β1). Angiotensin II receptor blockers (ARBs) have been shown to lead to upstream inhibition of TGF-β1 in several disease processes and proposed as a potential pharmacologic treatment in DD. The purpose of this study was to assess the association of ARBs with DD procedures and recurrence.

We queried the PearlDiver national insurance dataset to identify patients with a diagnosis of DD and at least 3 years of follow-up. A 1:1 matched cohort was made of patients who were not taking ARBs, and the primary outcome was the rate of index procedures for DD. A second 1:1 matched-control cohort was made among those with an index procedure, to assess for the rate of subsequent procedures as a correlate for revision procedures. We used multivariable logistic regression to assess specific factors associated with initial and subsequent procedures.

The 3-year rate of index procedures was 21.9% in the ARB group and 17.6% in the control group (P < .001). The 3-year rate of subsequent procedures was 22.9% in the ARB group and 18.0% in the control group (P < .001). Angiotensin receptor blockers were independently associated with 1.32 higher odds of an index procedure (95% confidence interval [CI] 1.25-1.40) and 1.35 (95% CI 1.19-1.54) higher odds of a subsequent procedure.

Although we hypothesized that ARBs would be protective, our findings do not show an association with protection. Instead, the odds ratios suggest a higher risk of index and subsequent procedures.