According to CDC data, COPD accounted for about 6.9 million emergency room visits in 2014. Thus, novel therapies that can reduce this burden and improve the quality of life for patients with COPD would be tremendously impactful, says Sean Duffy, MD. While beta-blockers have been thought of as potentially harmful to patients with COPD due to a theoretical risk for increased bronchospasm with nonselective beta-blocker therapy, recent retrospective reviews suggest that these agents are safe and possibly protective in this patient population.

 

Adding to the Narrative

In order to add to the narrative regarding the safety and efficacy of beta-blockers in patients with COPD, Dr. Duffy and colleagues conducted a retrospective evaluation of associations between beta-blocker use and both exacerbation rates and longitudinal measures of lung function in two well-characterized COPD cohorts. The majority of the patients had moderate and severe airway obstruction and were deemed at risk for exacerbation. “Cardiac comorbidities were largely excluded from one of the studies, so we could assess patients with and without cardiac disease to determine if there was a different effect based on the presence or absence of comorbid cardiac disease,” adds Dr. Duffy.

The study team found no statistically significant differences between the groups in exacerbation rate or spirometry results, regardless of the presence or absence of cardiac comorbidities. “Our analysis provides more evidence that beta-blockers are safe to use in patients with moderate-to-severe COPD who are already at risk for exacerbation,” Dr. Duffy says. “Clinicians should not shy away from prescribing these agents when appropriate to patients with moderate or severe COPD.”

References

Duffy S, Marron R, Voelker, et al. Effect of beta-blockers on exacerbation rate and lung function in chronic obstructive pulmonary disease (COPD). Respir Res. 2017;18:124. Available at
https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-017-0609-7.

Criner G, Connett J, Aaron S, et. al. Simvastatin for the prevention of exacerbations in moderate-to-severe COPD. N Eng J Med. 2014;370:2201-2210

Albert R, Connett J, Bailey W, et al. Azithromycin for prevention of exacerbations of COPD. N Engl J Med. 2011;365:689-698.