β-blockers in Chronic Obstructive Pulmonary Disease: a Cohort Study from the TONADO® Research Programme.
Chest. 2018 Jan 16;:
Authors: Maltais F, Buhl R, Koch A, Amatto VC, Reid J, Grönke L, Bothner U, Voß F, McGarvey L, Ferguson GT
BACKGROUND: Cardiovascular disease is a frequent co-morbidity in patients with chronic obstructive pulmonary disease (COPD). Many clinicians, particularly pulmonologists, are reluctant to use β-adrenoceptor blocking agents (β-blockers) in patients with COPD, despite their proven effectiveness in preventing cardiovascular events.
METHODS: The large (5,162 patients) phase III TONADO® 1 and 2 studies assessed lung function and patient-reported outcomes (PROs) in patients with moderate to very severe COPD receiving long-acting bronchodilator treatment over 1 year. This post hoc analysis characterised lung-function changes, PROs and safety in the subgroup of patients receiving β-blockers in the studies.
RESULTS: In total, 557/5,162 patients (11%) received β-blockers at baseline. Post-bronchodilator FEV1 at baseline was higher in the β-blocker group (1.470 L) compared to the no β-blocker group (1.362 L). As expected, patients on β-blockers had a more frequent history of cardiovascular co-morbidities and medications. Lung function improved from baseline in patients with or without β-blocker treatment, and no relevant between-group differences were observed in trough FEV1 or trough FVC at 24 or 52 weeks. No relevant differences were observed for SGRQ and Transition Dyspnoea Index in patients with β-blockers compared to those without. Safety findings were comparable between groups.
CONCLUSIONS: Lung function, overall respiratory status and safety of tiotropium/olodaterol were not influenced by baseline β-blocker treatment in patients with moderate to very severe COPD. Results from this large patient cohort support the cautious and appropriate use of β-blockers in patients with COPD and cardiovascular co-morbidity.
TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01431274 and NCT01431287; URL: www.clinicaltrials.gov.
PMID: 29355547 [PubMed - as supplied by publisher]