Table 2 Clinical trials that have addressed the effect of beta-blockers on clinical of functional pulmonary outcomes in patients with concomitant cardiac and obstructive respiratory conditions
From: Beta-blockers in patients with chronic obstructive disease and coexistent cardiac illnesses
Population/design | n | Drug (mean daily dose) | Follow-up | Outcomes | |
|---|---|---|---|---|---|
Hawkins et al. [82] | HF with moderate COPD/randomized, controlled, double-blinded | 27 (14/13) | Bisoprolol (7.3 mg) vs placebo | 4 month | FEV1 significantly decreased (−70 vs. +120 ml) |
SF-36↑ n.s. 2.6 vs 0.5 | |||||
No increase in exacerbations | |||||
Kotlyar et al. [88] | HF with moderate COPD o Asma/quasi-experimental | 31COPD/12 Asthma | Carvedilol | 2.4 year | In 1 COPD (3 %) and 3 asthmatics (25 %) the drug had to be withdraw because of worsening of the respiratory condition |
(29 mg COPD/19 mg asthma) | |||||
Lainscak et al. [89] | Elderly HF with moderate COPD/randomized, controlled, open-label | 63 (32/31) | Bisoprolol (47 mg) vs Carvedilol (6.4 mg) | 4–6 weeks | 1 patient of the carvedilol group had to be withdrawn because of “wheezing”, no differences between groups in the number of patients in which the BB had to be suspended (3 each). FEV1 significantly increased in bisoprolol (~130 ml) but not carvedilol (~30 ml) |
Jabbour et al. [90]. | HF with moderate COPD/randomized, open label, triple-crossover | 35 | Bisoprolol vs metoprolol vs carvedilol equivalent dose but mean not specified | 6 month | FEV1 ~ 150 ml or 8 % higher with bisoprolol and metoprolol than with carvedilol |
Camrari et al. [92] | CAD with moderate to severe COPD/quasi-experimental | 50 | Metoprolol | 3 month | No change in FEV1 |
(93 mg CR or 189 mg conventional) | |||||
No adverse events | |||||
Dorow et al. [91] | CAD with moderate COPD/randomized, double-blind crossover | 40 | Atenolol (50 mg) vs bisoprolol (5 mg) | 6 month | FEV1 declined significantly (~0.2 l) in both treatment arms. |
(20/20) |