Metoprolol Safer Beta Blocker for Asthma Patients, Surprising Findings from FDA's large database

Metoprolol Safer Beta Blocker for Asthma Patients, Reveals FAERS Database Analysis.

A new analysis of the FDA's Adverse Event Reporting System (FAERS) has identified metoprolol as a safer β-Blockers for asthma patients compared to other drugs in its class.

The results of the Analysis have recently been published in the Respiratory Medicine Journal.

The study reviewed over 250,000 adverse events associated with β-Blockers, focusing on 4,104 asthma-related cases.

Among these, metoprolol emerged as one of the safer options, with a lower reporting odds ratio for asthma-related events. In contrast, drugs like bisoprolol and betaxolol presented higher risks.

According to the study, drugs like metoprolol and nadolol posed reduced asthma risks, making them preferable for patients with coexisting cardiovascular and respiratory conditions. However, caution is advised with β-Blockers like propranolol and timolol, which may exacerbate asthma symptoms.

β-blockers play a critical role in managing cardiovascular diseases (CVDs) but may induce respiratory complications, particularly in patients with asthma or reactive airway diseases.

Some of the Key Highlights of the Study are:

• Selective β1-Blockers exhibited a higher asthma risk signal (ROR: 1.15). The findings suggested that individuals who use selective β1-blockers are 15 % more likely to report asthma-related events compared to those who do not use these drugs. However, Drugs like bisoprolol showed elevated risks, while metoprolol showed a safer profile.
• Dual α- and β-Blockers hydrophilic and lipophilic β-blockers posed lower asthma risks, whereas selective β1-blockers consistently showed higher risks, irrespective of intrinsic sympathomimetic activity.
• The study highlighted safer options include Metoprolol, esmolol, nebivolol, and nadolol, while higher-risk drugs are bisoprolol, betaxolol, timolol, and propranolol.

This study concludes that clinicians must weigh cardiovascular benefits against respiratory risks to ensure optimal patient outcomes.

*Food and Drug Administration’s Adverse Event Reporting System (FAERS), ROR: Reporting Odds Ratios

Reference: 

1) Cazzola M, Ora J, Calzetta L, Rogliani P, Matera MG. β-Blockers and Asthma: Surprising findings from the FAERS database. Respir Med. 2024 Nov-Dec;234:107849. doi: 10.1016/j.rmed.2024.107849. Epub 2024 Oct 28. PMID: 39490635.