Tolerability of Bisoprolol on Domiciliary Spirometry in COPD

Lung. 2018 Feb;196(1):11-14. doi: 10.1007/s00408-017-0061-y. Epub 2017 Oct 14.

Abstract

We investigated if serial domiciliary measures of spirometry were sensitive at detecting subtle effects of beta-2 blockade associated with bisoprolol in (n = 17) patients with COPD. After a two-week run in on inhaled corticosteroid (ICS) and long acting beta-2 agonist (LABA): beclometasone/formoterol 100/6 µg, patients' started additional a long acting muscarinic receptor antagonist: (LAMA) Tiotropium 18 µg, with concomitant weekly dose titration of bisoprolol: 1.25-2.5-5 mg. After a further week of bisoprolol 5 mg, they were stepped back down to (ICS/LABA) for one week. Mean age was 64 years, mean FEV1 52% predicted, and mean FEV1/FVC ratio of 0.46. Compared to baseline am FEV1 of 1.38 L (95% CI 1.14-1.61 L), both ICS/LABA/LAMA and ICS/LABA in conjunction with bisoprolol showed statistically significant mean falls of 100 ml (1.28 L, 95% CI 1.03-1.53 L), and 120 ml, respectively (1.26 L, 95% CI 1.01-1.51 L); equalling and exceeding the MCID of 100 ml, respectively. These changes were disconnected from symptoms, reliever use and oxygen saturation.

Keywords: Beta blocker; COPD; FEV1; FEV6; Spirometry.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adrenergic beta-1 Receptor Antagonists / adverse effects*
  • Adrenergic beta-2 Receptor Agonists / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage
  • Beclomethasone / administration & dosage
  • Bisoprolol / adverse effects*
  • Drug Therapy, Combination
  • Female
  • Forced Expiratory Volume / drug effects
  • Formoterol Fumarate / administration & dosage
  • Heart Rate / drug effects
  • Humans
  • Male
  • Middle Aged
  • Muscarinic Antagonists / therapeutic use
  • Oxygen / blood
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Spirometry / methods*
  • Tiotropium Bromide / therapeutic use
  • Vital Capacity / drug effects

Substances

  • Adrenergic beta-1 Receptor Antagonists
  • Adrenergic beta-2 Receptor Agonists
  • Anti-Inflammatory Agents
  • Muscarinic Antagonists
  • Beclomethasone
  • Oxygen
  • Formoterol Fumarate
  • Tiotropium Bromide
  • Bisoprolol