Beta-blocker therapy in patients with COPD: a systematic literature review and meta-analysis with multiple treatment comparison.
Background: Beta-blockers are associated with reduced mortality in patients with cardiovascular disease but are often under prescribed in those with concomitant COPD, due to concerns regarding respiratory side-effects. We investigated the effects of beta-blockers on outcomes in patients with COPD an...
| Publicado en: | Respiratory Research Vol. 22; no. 1; pp. 1 - 15 |
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| Autores principales: | , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
BioMed Central
2/23/2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148903660&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148903660 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14659921 1D0T jtl: Respiratory Research issn: 14659921 maglogo: N pubinfo: dt: 2/23/2021 vid: 22 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 148903660 148903660 NLM33622362 148903660 10.1186/s12931-021-01661-8 NLM33622362 148903660 ppf: 1 ppct: 14 formats: tig: atl: Beta-blocker therapy in patients with COPD: a systematic literature review and meta-analysis with multiple treatment comparison. aug: au: Gulea, Claudia Zakeri, Rosita Alderman, Vanessa Morgan, Alexander Ross, Jack Quint, Jennifer K. affil: National Heart and Lung Institute, Imperial College London, Manresa Road, London, UK sug: subj: Adrenergic beta-Antagonists Therapeutic Use Pulmonary Disease, Chronic Obstructive Drug Therapy Disease Progression Human Meta Analysis Systematic Review ab: Background: Beta-blockers are associated with reduced mortality in patients with cardiovascular disease but are often under prescribed in those with concomitant COPD, due to concerns regarding respiratory side-effects. We investigated the effects of beta-blockers on outcomes in patients with COPD and explored within-class differences between different agents.Methods: We searched the Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medline for observational studies and randomized controlled trials (RCTs) investigating the effects of beta-blocker exposure versus no exposure or placebo, in patients with COPD, with and without cardiovascular indications. A meta-analysis was performed to assess the association of beta-blocker therapy with acute exacerbations of COPD (AECOPD), and a network meta-analysis was conducted to investigate the effects of individual beta-blockers on FEV1. Mortality, all-cause hospitalization, and quality of life outcomes were narratively synthesized.Results: We included 23 observational studies and 14 RCTs. In pooled observational data, beta-blocker therapy was associated with an overall reduced risk of AECOPD versus no therapy (HR 0.77, 95%CI 0.70 to 0.85). Among individual beta-blockers, only propranolol was associated with a relative reduction in FEV1 versus placebo, among 199 patients evaluated in RCTs. Narrative syntheses on mortality, all-cause hospitalization and quality of life outcomes indicated a high degree of heterogeneity in study design and patient characteristics but suggested no detrimental effects of beta-blocker therapy on these outcomes.Conclusion: The class effect of beta-blockers remains generally positive in patients with COPD. Reduced rates of AECOPD, mortality, and improved quality of life were identified in observational studies, while propranolol was the only agent associated with a deterioration of lung function in RCTs. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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