PT  - JOURNAL ARTICLE
AU  - Philip Short
AU  - William Anderson
AU  - Peter Williamson
AU  - Brian Lipworth
TI  - Chronic dosing effects of propranolol in asthma
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P3647
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P3647.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P3647.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - ObjectivesUnblinded studies have shown improvements in airway hyper-responsiveness (AHR) with chronic nadolol in steroid naïve asthmatics. To assess the effects of chronic non selective beta-blockade as add on to inhaled corticosteroids (ICS) in asthmatics.MethodsA double-blind randomised placebo controlled crossover trial of propranolol in mild-to-moderate asthmatics receiving ICS was performed. Participants underwent a six to eight week dose titration of propranolol or placebo as tolerated to a maximum of 80mg per day. Tiotropium was given for the first four to six weeks of each treatment period. Primary outcome was methacholine challenge. Secondary outcomes included histamine challenge, pulmonary function, mini-asthma quality of life questionnaire (mini-AQLQ) and asthma control questionnaire (ACQ).Results18 patients completed: mean (SEM); age 36 (4), FEV1% 93 (2), ICS ug/day 440 (66). No significant difference was observed in methacholine or histamine challenge following exposure to propranolol versus placebo. For methacholine challenge the doubling dilution difference (DDD) was 0·04 (95%CI -0·56 - 0·63), p=0·89. Salbutamol recovery at 20mins post histamine challenge was partially attenuated by propranolol vs placebo, FEV1% mean difference: 5.28 (95%CI 2.54-8.01), p=0.001. Post chronic beta-blockade there was a small worsening in FEV1 % predicted of 2·4% (95%CI -0·1 - 4·8), p=0·055. No difference was found for ACQ or mini-AQLQ.ConclusionsThis is the first placebo controlled study to assess the effects of chronic non selective beta-blockade in asthma, showing no significant effect of propranolol compared to placebo on either methacholine or histamine AHR and no change in ACQ or AQLQ.