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Evidence summaries

Cardioselective Beta-Blockers for Chronic Obstructive Pulmonary Disease

Cardioselective beta-blockers appear not to produce significant short-term reduction in airway function when given to patients with COPD. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 11 studies of single-dose treatment (n=131) and 11 of treatment for longer durations (2 days to 16 weeks; n=185, 1 436 patient-weeks). Cardioselective beta-blockers included in the study were atenolol, metoprolol, bisoprolol, practolol, celiprolol and acebutolol.

Cardioselective beta-blockers produced no significant change in FEV1 or respiratory symptoms compared to placebo, given as a single dose (MD -2.08%, 95% CI -5.25 to 1.09%) or for longer duration (MD -2.73%, 95% CI -6.03 to 0.57), and did not significantly affect the FEV1 treatment response to beta2-agonists.

A subgroup analysis revealed no significant change in results for those participants with severe chronic airways obstruction, those with a reversible obstructive component, or those with concomitant cardiovascular disease.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).

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    References

    • Salpeter S, Ormiston T, Salpeter E. Cardioselective beta-blockers for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2005 Oct 19;(4):CD003566 [Review content assessed as up-to-date: 17 August 2010]. [PubMed]

Primary/Secondary Keywords