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 language||English (US)|
|State||Published - Jun 19 2017|
Bibliographical noteFunding Information:
Stephen Lazrus, MD-No financial considerations for this manuscript. Has received a grant from NIH-NHLBI for a past study and has received compensation for travel expenses to travel to CCRN Steering Meetings. Dennis Niewoehner, MD-No financial consideration for this manuscript. In the past his institution has been awarded an NHLBI grant. Has been compensated as a consultant by Boehringer Ingelheim, Astra Zeneca, Glaxo SmithKline, Forest Research, Merck, Sanofi Aventis, Bayer Schering, Nycomed, Protaffin, and Pfizer. Paul D. Scanlon, MD-No financial consideration for this manuscript. In the past has received institutional NHLBI grants and travel compensation. Has also received institutional grants from Dept. of Energy, Altana, Boehringer Ingelheim, Dey L.P. Pharmaceutical, Forest, Glaxo SmithKline, Novartis AG, and Pfizer. Has received royalties from Lippincott, Williams & Wilkins/Wolters Kluwer. Frank Sciurba, MD-No relevant disclosures in 36 months prior to the submission of this manuscript. Stephen Scharf, MD-No financial consideration for this manuscript. Has received an NIH grant to his institution, as well as NIH travel compensation and payment from the NIH for writing or reviewing of a manuscript. Robert M. Reed, MD-None George Washko, MD-No financial consideration for this manuscript. He has been compensated as consultant by MedImmune and Spiration. Prescott Woodruff, MD, MPH-No financial consideration for this manuscript. Has been compensated as a consultant by MedImmune. Has received an institutional grant from Genentech. Has a patent or a patent pending for an asthma biomarker. Charlene McEvoy, MD, MPH-No financial consideration for this manuscript. Has received a grant and travel expenses reimbursement by the NHLBI in the past. Has received and institutional grant from NHLBI, Boston Scientific, COPD Foundation, and Glaxo SmithKline. Has received speaking fees from Boehringer Ingelheim and Glaxo SmithKline. Shawn Aaron, MD-None Don Sin, MD, MPH-No financial considerations for this manuscript. In the past 36 months he has received grants from Astra Zeneca, Merck, and Boehringer Ingelheim. Gerard J. Criner, MD-No financial considerations for this manuscript. He has been awarded a grant for his institution from the NHLBI for other work. Other grants from Boehringer-Ingelheim, Novartis, Astra Zeneca. He has received royalties from Springer for a book publication.
© 2017 The Author(s).