Inpharma 1371 - 25 Jan 2003

Cardioselective β-blockers safe inpatients with reactive airway

disease?Cardioselective β-blockers should not be withheld

from patients with mild-to-moderate reactive airwaydisease, according to researchers from the US.

They conducted a meta-analysis of 29 trials toevaluate the effect of cardioselective β-blockers onrespiratory function in patients with reactive airwaydisease.* They evaluated 19 studies which used a single-dose of cardioselective β-blockers (240 participants,mean age 40.1 years) and ten studies that provided dataon 3 days to 4 weeks of treatment (141 participants,mean age 51.3 years).

The researchers found that, compared with placebo,single doses of cardioselective β-blockers wereassociated with a small reduction in forced expiratoryvolume (FEV1). In contrast, in the ten studies ofcontinued cardioselective β-blocker treatment neitherFEV1 response nor incidence of inhaler use differedsignificantly between those who receivedcardioselective β-blockers and those who receivedplacebo. Both single-dose and continued use ofcardioselective β-blockers was associated with anincrease in FEV1 after a β2-agonist was given.

The researchers note that, while the first dose of acardioselective β-blocker produced a small decrease inFEV1 compared with placebo, this was not associatedwith adverse respiratory effects and that after continuedtreatment, FEV1, symptoms and inhaler use did notdiffer.* defined as asthma or chronic obstructive pulmonary disease with areversible obstructive component

Salpeter SR, et al. Cardioselective beta-blockers in patients with reactive airwaydisease: a meta-analysis. Annals of Internal Medicine 137: 715-725, 5 Nov2002 800926480

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Inpharma 25 Jan 2003 No. 13711173-8324/10/1371-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved