Key result
Metoprolol resulted in a similar risk of COPD exacerbations compared to placebo, but was associated with a higher risk of exacerbation leading to mechanical ventilation and worsening breathlessness.
Why the study?
To investigate the influence of metoprolol compared with placebo on the risk of COPD exacerbations.
Does metoprolol reduce the risk of exacerbations in patients with moderate to severe COPD with no prior indication for beta blockers?
RCT
Does metoprolol reduce the risk of exacerbations in patients with moderate to severe COPD with no prior indication for beta blockers?
In patients with moderate to severe COPD without a primary indication for beta-blockers, metoprolol did not prevent exacerbations and was associated with an increased risk of severe exacerbations requiring mechanical ventilation.
Answers are grounded in this paper and cite their sources.
Metoprolol warrants caution in COPD; challenges beta-blocker safety assumptions and extends RCT evidence on respiratory risks.
Synopsis: This prospective randomized trial investigates the influence of metoprolol in comparison with placebo on the risk of chronic obstructive pulmonary disease exacerbations. Contrary to results in previous observational studies, the results showed that patients with moderate to severe chronic obstructive pulmonary disease, with no prior indication for beta blockers, were at similar risk for exacerbations as the placebo group. The metoprolol group was associated with a higher risk of exacerbation leading to mechanical ventilation. In addition, metoprolol was associated with worsening symptoms of breathlessness. Source: Dransfield MT, Voelker H, Bhatt SP et al, BLOCK COPD Trial Group. Metoprolol for the prevention of acute exacerbations of COPD. N Engl J Med. 2019; October 20.
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Lee et al. (2020) conducted an RCT in Chronic obstructive pulmonary disease. Metoprolol vs. Placebo was evaluated on Chronic obstructive pulmonary disease exacerbations. Metoprolol resulted in a similar risk of COPD exacerbations compared to placebo, but was associated with a higher risk of exacerbation leading to mechanical ventilation and worsening breathlessness.
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