β-Blockers in COPD: A Cohort Study From the TONADO Research Program.

Autor: Maltais F; Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, QC, Canada. Electronic address: Francois.Maltais@fmed.ulaval.ca., Buhl R; Pulmonary Department, Mainz University Hospital, Mainz, Germany., Koch A; Medizinische Klinik und Poliklinik V, Klinikum der Ludwig-Maximilians-Universität, and the German Center for Lung Research (DZL), Klinikum der Ludwig-Maximilians-Universität, Munich, Germany., Amatto VC; Boehringer Ingelheim International GmbH, Ingelheim, Germany., Reid J; Dunedin School of Medicine, University of Otago, Dunedin, New Zealand., Grönke L; Boehringer Ingelheim International GmbH, Ingelheim, Germany., Bothner U; Boehringer Ingelheim International GmbH, Ingelheim, Germany., Voß F; Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany., McGarvey L; Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland., Ferguson GT; Pulmonary Research Institute of Southeast Michigan, Farmington Hills, MI.
Jazyk: angličtina
Zdroj: Chest [Chest] 2018 Jun; Vol. 153 (6), pp. 1315-1325. Date of Electronic Publication: 2018 Jan 31.
DOI: 10.1016/j.chest.2018.01.008
Abstrakt: Background: Cardiovascular disease is a frequent comorbidity in patients with COPD. Many physicians, 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 in patients with moderate to very severe COPD receiving long-acting bronchodilator treatment across 1 year. This post hoc analysis characterized lung-function changes, patient-reported outcomes, and safety in the subgroup of patients receiving β-blockers in the studies.
Results: In total, 557 of 5,162 patients (11%) received β-blockers at baseline. Postbronchodilator FEV 1 at baseline was higher in the β-blocker group (1.470 L) compared with that in the no β-blocker group (1.362 L). As expected, patients receiving β-blockers had a more frequent history of cardiovascular comorbidities and medications. Lung function improved from baseline in patients with or those without β-blocker treatment, and no relevant between-group differences were observed in trough FEV 1 or trough FVC at 24 or 52 weeks. No relevant differences were observed for St. George's Respiratory Questionnaire results and Transition Dyspnea Index in patients with β-blockers compared with those in patients 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 comorbidity.
Trial Registry: ClinicalTrials.gov; No.: NCT01431274 and No. NCT01431287; URL: www.clinicaltrials.gov.
(Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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