Beta-blockers in Chronic Obstructive Pulmonary Disease: a Cohort Study from the TONADO Research Programme

François Maltais, R. Buhl, A. Koch, Valeria Amatto, Jim Reid, Lars Grönke, Ulrich Bothner, Florian Voß, Lorcan McGarvey, Gary T Ferguson

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Abstract

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 (5,163 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, 557/5,163 patients (11%) received β-blockers at baseline. Post-bronchodilator trough FEV1 at baseline was higher in the β-blocker group (1.476 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 between 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.
Original languageEnglish
Pages (from-to)1315-1325
JournalChest
Volume153
Issue number6
Early online date31 Jan 2018
DOIs
Publication statusEarly online date - 31 Jan 2018

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    Maltais, F., Buhl, R., Koch, A., Amatto, V., Reid, J., Grönke, L., Bothner, U., Voß, F., McGarvey, L., & Ferguson, G. T. (2018). Beta-blockers in Chronic Obstructive Pulmonary Disease: a Cohort Study from the TONADO Research Programme. Chest, 153(6), 1315-1325. https://doi.org/10.1016/j.chest.2018.01.008