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EBM verdict
Primary care
Metoprolol is not effective for preventing acute exacerbations in COPD
Free
  1. Igho J Onakpoya
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Dr Igho J Onakpoya, Primary Care, University of Oxford, Oxford OX1 2JD, UK; igho.onakpoya{at}phc.ox.ac.uk

https://doi.org/10.1136/bmjebm-2019-111313

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    Results of observational studies suggest that beta-blockers have a role in preventing acute exacerbations of COPD, however a recent randomised controlled trial demonstrates it may cause more harm than good.

    Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a major contributor to morbidity and mortality. Reductions in the frequency and severity of such exacerbations improve long-term clinical outcomes and quality of life.1 Previous meta-analyses of observational studies have suggested that beta-blockers may be beneficial in the management of COPD.2 3

    The BLOCK COPD (Beta-Blockers for the Prevention of Acute Exacerbations of COPD) study was a multicentre, randomised, placebo-controlled clinical trial (n=532) that assessed the …

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