Review: cardioselective {beta} blockers do not produce adverse respiratory effects in COPD

doi:10.1136/ebm.11.3.84

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Evidence-Based Medicine 2006;11:84; doi:10.1136/ebm.11.3.84
Copyright © 2006 by the BMJ Publishing Group Ltd.

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Therapeutics

Review: cardioselective ß blockers do not produce adverse respiratory effects in COPD

Salpeter S, Omiston T, Salpeter E. Cardioselective beta-blockers for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2005;(4):CD003566.

Q In patients with chronic obstructive pulmonary disease (COPD), do cardioselective ß blockers cause adverse respiratory effects?

Clinical impact ratings GP/FP/Primary care $*$ $*$ $*$ $*$ $*$ $*$ $*$ IM/Ambulatory care $*$ $*$ $*$ $*$ $*$ ${star}$ ${star}$ Cardiology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Respirology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$

Key Words: adrenergic beta antagonists • pulmonary disease (chronic obstructive)

The first 150 words of the full text of this article appear below.

METHODS
Data sources Cochrane Central Register of Controlled Trials, Medline, EMBASE/ExcerptaMedica, CINAHL, respiratory journals, meeting abstracts, andrelevant references (up to May 2005).

Study selection and assessment randomised, blinded, controlled trials (RCTs) in any languagethat evaluated cardioselective ß blockers as a singledose or for an extended period in patients with COPD and reportedchange in FEV₁ or respiratory symptoms. Administration of ß₂agonists, either intravenously or by inhalation, after cardioselectiveß blockers or placebo, was also studied. 20 RCTs (allcrossover trials) met the selection criteria. 11 trials (n =131, mean age 53.8 y, 80% men) evaluated a single dose of cardioselectiveß blockers, and 9 trials (n = 147) reported longerduration (mean 3.7 wk). Study quality was assessed for randomisationand blinding.

Outcomes change in FEV₁, FEV₁ response to ß₂ agonists, andrespiratory symptoms (wheezing, dyspnoea, or COPD exacerbation).

MAIN RESULTS
Meta-analyses showed that a single . . . [Full text of this article]

Yves Lacasse, MD, MSc, FRCPC

Hôpital Laval, Université Laval
Sainte Foy, Québec, Canada