RT Journal Article
SR Electronic
T1 The effect of the indicated use of ß-blockers on the risk of COPD exacerbations: the Rotterdam Study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 5233
DO 10.1183/13993003.congress-2020.5233
VO 56
IS suppl 64
A1 Leila Karimi
A1 Guy Brusselle
A1 Lies Lahousse
A1 Phebe De Nocker
A1 Bruno H Stricker
A1 Katia M C Verhamme
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/5233.abstract
AB Background: While observational studies suggest a reduced risk of exacerbation in COPD patients treated with β-blockers (BB), there is reluctance to prescribe BB in patients with cardiovascular disease (CVD) and concomitant COPD. Recently, the BLOCK COPD trial reported an increased risk of exacerbation in metoprolol treated COPD patients without a therapeutic indication (TI) for such drug. The current discrepancy between findings from observational studies and the BLOCK COPD trial might result in even less prescribing BB in COPD patients with a cardiac indication.Aim: To examine whether the association between use of BB and risk of COPD exacerbations differed between patients with and without a TI for BB use.Methods: Within the Rotterdam Study, we followed 1,312 COPD subjects until the first COPD exacerbation or end of follow-up. We defined TI for BB use as having hypertension, coronary heart disease, atrial fibrillation, or heart failure at baseline. The association between BB use, as a time-varying variable, and COPD exacerbations was assessed using Cox proportional hazards models adjusted for age, sex, smoking, and other potential confounders.Results: In patients with a TI for BB (n=755, mean age=70.4±9) current use of cardioselective BB (CSBB) was associated with a reduced risk of COPD exacerbations (HR=0.69, 95%CI:0.57-0.85). In contrast, in subjects without a TI for BB (n=557, mean age=68.8±10) use of CSBB was not associated with an altered risk of COPD exacerbations.Conclusion: Use of CSBB reduced the risk of exacerbations only in COPD patients with concomitant CVD. Our results could explain the discordant findings between the BLOCK COPD trial and observational studies.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 5233.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).