JAMA

ATS 2024: Beta-blocker fails to cut COPD exacerbations

May 21, 2024

Among patients with COPD at high risk of exacerbation, treatment with the β1-selective β-blocker bisoprolol didn’t reduce the number of self-reported COPD exacerbations requiring treatment with oral corticosteroids, antibiotics, or both. Trial results were presented at the American Thoracic Society annual meeting in San Diego, CA.

The double-blind, placebo-controlled Bisoprolol in COPD Study (BICS) enrolled patients with COPD who had at least moderate airflow obstruction on spirometry (FEV1:FVC <0.7; FEV1 <80% predicted) and at least 2 COPD exacerbations treated with oral corticosteroids, antibiotics, or both in the prior 12 months. Participants were randomly assigned to bisoprolol (n = 261) or placebo (n = 258). Bisoprolol was started at 1.25 mg PO daily and titrated to a max dose of 5 mg/day. Although the trial planned to enroll 1,574 patients, recruitment was suspended from March 2020 to July 2021, due to the COVID-19 pandemic.

Among 515 patients (mean age, 68 years; 53% male; mean FEV1, 50.1%), primary outcome data were available for 514 patients and 371 (72.0%) continued taking the study drug. The number of patient-reported COPD exacerbations treated with oral corticosteroids, antibiotics, or both was 526 in the bisoprolol group (mean exacerbation rate, 2.03/year) vs. 513 in the placebo group (mean exacerbation rate, 2.01/year). Adjusted incidence rate ratio was 0.97 (95% confidence interval, 0.84-1.13; P = 0.72). The rate of serious adverse events was 14.5% in the bisoprolol group vs. 14.3% in the placebo group (relative risk, 1.01; 95% CI, 0.62-1.66; P = 0.96).

Source:

Devereux G, et al. (2024, May 19). JAMA. Bisoprolol in Patients With Chronic Obstructive Pulmonary Disease at High Risk of Exacerbation: The BICS Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/38762800/