If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email 'It appears that individuals with COPD who took the beta-blockers had better outcomes than those who did not," he tells WebMD.The study, he writes in his editorial, "has turned the story of beta-blockers in COPD into a curious case of a foe becoming a potential friend to millions of patients with COPD worldwide. Your doctor will choose which beta blocker is best for you based on your health conditions. "This is a very important study." In patients with high blood pressure, beta-blockers do not seem to have any particular advantage over other hypotensive agents. Meeting Coverage > CHEST Beta-Blockers Best Avoided in COPD Patients Without CVD — Trial appears to settle an outstanding clinical question. Patients were excluded if they were already taking a beta blocker or if they had established indications for use of the drug.Mean patient age was 65 and just over half were men. The median time to the first exacerbation of COPD was 202 days in the metoprolol group and 222 days in the placebo group, for a hazard ratio of 1.05 (95% CI, 0.84–1.32; P=0.66). To investigate this association, the authors searched MEDLINE and EMBASE for studies assessing COPD exacerbation rates in patients on beta-blocker therapy. by Salynn Boyles, Contributing Writer October 21, 2019
About half were current or former smokers. Continuing Selective Beta Blockers Safe During COPD Exacerbations. ''Our study is the first that clearly gives a hint that beta-blockers could also exert a pulmonary beneficial effect as shown by their reduction of exacerbations," says study researcher Frans Rutten, MD, PhD, an assistant professor of medicine at the Julius Center for Health Sciences and Primary Care at the University Medical Center Utrecht, Netherlands.Research in 2002 showed that beta-blockers that are cardioselective (preferentially affecting the In the new study, Rutten and his colleagues looked at 2,230 men and women, age 45 and older, who had gotten a diagnosis of COPD between 1996 and 2006. Cardiovascular disease is common in patients with COPD.
Says Don Sin, MD, MPH, a professor of medicine and a lung specialist at the University of British Columbia and the Providence Heart and Lung Institute in Vancouver, who wrote an editorial to accompany the study. Median values for this measure were 202 and 222 days for patients in the metoprolol and placebo groups, respectively, though the difference did not reach statistical significance.Side effects were also similar in the two groups, although deaths with metoprolol outnumbered those in the placebo group, at 11 to five.No significant between-group differences were identified in change from baseline in FEVRates of hospitalization for any cause were 0.66 per person-year in the metoprolol group and 0.42 per person-year in the placebo group (He noted that there is little evidence that beta-blockers are currently being prescribed in COPD patients without therapeutic indications for their use. Findings from several observational studies suggested that beta-blockers do reduce mortality risk and respiratory events in these patients, but randomized trials were absent. COPD includes In the study, nearly 30% were on beta-blockers while others were on different kinds of cardiovascular drugs, sometimes in combination.During the 7.2-year average follow-up, 686 patients, or about 31%, died, and 47.3% or 1,055, had at least one episode of worsening of COPD.Those who took a beta-blocker were 32% less likely to die during the study follow-up and 39% less likely to have worsening of COPD than those who didn't use the drugs.Ideally, Rutten says, the next step is to compare beta-blockers with The new study results may change practice, according to two doctors familiar with the study. by Blair Westerly, MD. "This research was funded by the U.S. Department of Defense.Dransfield reported receiving consulting fees from AstraZeneca, GlaxoSmithKline, Mereo, PneumRx/BTG, and others.The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.
"On the contrary, there is good evidence that physicians are still reluctant to prescribe beta-blockers even in patients with COPD who have proven cardiac indications," MacNee wrote. ""For years, people have automatically assumed that beta-blockers were unhealthy for asthmatic and COPD patients," he says.
In myocardial infarction, relatively late use of a beta-blocker …
"If patients with COPD do not have these indications, they should not be on the drug," he said.Commenting on the study findings at Dransfield's presentation, Gerard J. Criner, MD, of the Lewis Katz School of Medicine at Temple University, Philadelphia, noted that while beta blockers are still indicated in patients with heart failure and ischemic heart disease, their use in other groups, including COPD patients without CVD, should be reevaluated.