Beta-blockers 'reduce COPD exacerbations'

COPD patients have fewer respiratory exacerbations and live longer if they are given beta-blockers, a Dutch study has shown.

COPD patients benefit from being treated with beta-blockers (Photograph: SPL)
COPD patients benefit from being treated with beta-blockers (Photograph: SPL)

Use of beta-blockers in patients with COPD is often avoided because of concerns about adverse effects on the lungs, researchers point out.

Dr Frans Rutten and colleagues from the University Medical Centre Utrecht in the Netherlands studied data from 2,230 patients with COPD, including 665 on beta-blocker therapy.

Among patients given beta-blocker therapy, 43 per cent had at least one exacerbation, compared with 49 per cent of those not given beta-blockers.

In addition, 27 per cent of patients given beta-blockers died, compared with 32 per cent of patients not on beta-blocker therapy.

Dr Rutten and his team said the study was, to their knowledge, the first observational study to show beta-blockers may improve survival and reduce exacerbations in COPD.

Subgroup analyses showed that patients with COPD but without overt cardiovascular disease had similar results. The researchers also found that patients given beta-blockers did not show any overt cardiovascular comorbidities.

'Importantly, the reduction in risk of exacerbation of COPD by beta-blockers cannot easily be explained by cardiovascular effects alone,' they said.

'The association with survival also remained in the very small group of 44 patients who used beta-blockers as single-agent cardiovascular therapy, suggesting that beta-blockers offer a class-specific effect, independent of other cardiovascular drugs.'

Dr Rutten and colleagues argue that 'the time has come' to confirm their findings in a large scale study.

A separate study, published in JAMA this week, showed that early antibiotic treatment improved outcomes in patients admitted to hospital with acute exacerbations of COPD.

The researchers found that patients who received antibiotics within the first two days in hospital were less likely to req-uire mechanical ventilation or to be readmitted to hospital.

This benefit was maintained regardless of the risk of treatment failing in individual patients, the study showed.

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