Effect of beta-blockers on exacerbation rate and lung function in chronic obstructive pulmonary disease (COPD)

the NIH COPD Clinical Research Network and the Canadian Institutes of Health Research

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Beta-blockers are commonly prescribed for patients with cardiovascular disease. Providers have been wary of treating chronic obstructive pulmonary disease (COPD) patients with beta-blockers due to concern for bronchospasm, but retrospective studies have shown that cardio-selective beta-blockers are safe in COPD and possibly beneficial. However, these benefits may reflect symptom improvements due to the cardiac effects of the medication. The purpose of this study is to evaluate associations between beta-blocker use and both exacerbation rates and longitudinal measures of lung function in two well-characterized COPD cohorts. Methods: We retrospectively analyzed 1219 participants with over 180days of follow up from the STATCOPE trial, which excluded most cardiac comorbidities, and from the placebo arm of the MACRO trial. Primary endpoints were exacerbation rates per person-year and change in spirometry over time in association with beta blocker use. Results: Overall 13.9% (170/1219) of participants reported taking beta-blockers at enrollment. We found no statistically significant differences in exacerbation rates with respect to beta-blocker use regardless of the prevalence of cardiac comorbidities. In the MACRO cohort, patients taking beta-blockers had an exacerbation rate of 1.72/person-year versus a rate of 1.71/person-year in patients not taking beta-blockers. In the STATCOPE cohort, patients taking beta-blockers had an exacerbation rate of 1.14/person-year. Patients without beta-blockers had an exacerbation rate of 1.34/person-year. We found no detrimental effect of beta blockers with respect to change in lung function over time. Conclusion: We found no evidence that beta-blocker use was unsafe or associated with worse pulmonary outcomes in study participants with moderate to severe COPD.

Original languageEnglish (US)
Article number124
JournalRespiratory Research
Volume18
Issue number1
DOIs
StatePublished - Jun 19 2017

Fingerprint

Chronic Obstructive Pulmonary Disease
Lung
Comorbidity
Bronchial Spasm
Spirometry
Cardiovascular Diseases
Retrospective Studies
Placebos
Outcome Assessment (Health Care)

Keywords

  • Beta-blocker
  • COPD
  • Exacerbation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Effect of beta-blockers on exacerbation rate and lung function in chronic obstructive pulmonary disease (COPD). / the NIH COPD Clinical Research Network and the Canadian Institutes of Health Research.

In: Respiratory Research, Vol. 18, No. 1, 124, 19.06.2017.

Research output: Contribution to journalArticle

the NIH COPD Clinical Research Network and the Canadian Institutes of Health Research 2017, 'Effect of beta-blockers on exacerbation rate and lung function in chronic obstructive pulmonary disease (COPD)', Respiratory Research, vol. 18, no. 1, 124. https://doi.org/10.1186/s12931-017-0609-7
the NIH COPD Clinical Research Network and the Canadian Institutes of Health Research. Effect of beta-blockers on exacerbation rate and lung function in chronic obstructive pulmonary disease (COPD). Respiratory Research. 2017 Jun 19;18(1). 124. https://doi.org/10.1186/s12931-017-0609-7
the NIH COPD Clinical Research Network and the Canadian Institutes of Health Research. / Effect of beta-blockers on exacerbation rate and lung function in chronic obstructive pulmonary disease (COPD). In: Respiratory Research. 2017 ; Vol. 18, No. 1.
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abstract = "Background: Beta-blockers are commonly prescribed for patients with cardiovascular disease. Providers have been wary of treating chronic obstructive pulmonary disease (COPD) patients with beta-blockers due to concern for bronchospasm, but retrospective studies have shown that cardio-selective beta-blockers are safe in COPD and possibly beneficial. However, these benefits may reflect symptom improvements due to the cardiac effects of the medication. The purpose of this study is to evaluate associations between beta-blocker use and both exacerbation rates and longitudinal measures of lung function in two well-characterized COPD cohorts. Methods: We retrospectively analyzed 1219 participants with over 180days of follow up from the STATCOPE trial, which excluded most cardiac comorbidities, and from the placebo arm of the MACRO trial. Primary endpoints were exacerbation rates per person-year and change in spirometry over time in association with beta blocker use. Results: Overall 13.9{\%} (170/1219) of participants reported taking beta-blockers at enrollment. We found no statistically significant differences in exacerbation rates with respect to beta-blocker use regardless of the prevalence of cardiac comorbidities. In the MACRO cohort, patients taking beta-blockers had an exacerbation rate of 1.72/person-year versus a rate of 1.71/person-year in patients not taking beta-blockers. In the STATCOPE cohort, patients taking beta-blockers had an exacerbation rate of 1.14/person-year. Patients without beta-blockers had an exacerbation rate of 1.34/person-year. We found no detrimental effect of beta blockers with respect to change in lung function over time. Conclusion: We found no evidence that beta-blocker use was unsafe or associated with worse pulmonary outcomes in study participants with moderate to severe COPD.",
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AU - the NIH COPD Clinical Research Network and the Canadian Institutes of Health Research

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AU - Marron, Robert

AU - Voelker, Helen

AU - Albert, Richard

AU - Connett, John

AU - Bailey, William

AU - Casaburi, Richard

AU - Cooper, J. Allen

AU - Curtis, Jeffrey L.

AU - Dransfield, Mark

AU - Han, Mei Lan K.

AU - Make, Barry

AU - Marchetti, Nathaniel

AU - Martinez, Fernando

AU - Lazarus, Stephen

AU - Niewoehner, Dennis

AU - Scanlon, Paul D

AU - Sciurba, Frank

AU - Scharf, Steven

AU - Reed, Robert M.

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