Bisoprolol safe and effective for treating chronic obstructive pulmonary disease: Study

The meta-analysis of thirty-five studies comprising 3269 study participants revealed that bisoprolol improved exercise performance and lung function in COPD patients and also reduced inflammatory markers. This effect was independent of the absence or presence of heart failure (HF).

Chronic obstructive pulmonary disease is a common chronic disease characterized by persistent airflow limitation. COPD affects approximately 384 million people worldwide and is considered the third leading cause of death worldwide because of the exponential increase in mortality and morbidity.

Bisoprolol, a type of selective beta-blocker, is commonly used in the treatment of patients with cardiovascular diseases such as moderate or severe chronic stable HF, coronary artery disease and hypertension. Despite the overwhelming evidence of their benefit in COPD patients, using BBs and the optimal treatment regimen for BBs remain controversial.

Against the above background, Zhouzhou Feng, The First Clinical Medical College of Lanzhou University, Lanzhou City, People’s Republic of China, and colleagues aimed to evaluate bisoprolol's clinical safety and efficacy in chronic obstructive pulmonary disease patients.

This systematic review and meta-analysis was conducted following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analyses) statements. The primary outcome measures analyzed included: 6-minute walking distance (6MWD), Pulmonary function(FEV1, FEV1%, FVC), adverse events and inflammatory cytokines(IL-6, IL-8, CRP).

The analysis included thirty-five studies comprising 3269 study participants; 1650 in the bisoprolol group and 1619 in the control group.

The researchers reported the following findings:

· The effect of bisoprolol on lung function in patients with COPD, FEV1, MD (0.46), FEV1%, MD (−0.64), FVC, MD (0.20), the results all showed a statistically significant result.

· The effect of bisoprolol on 6MWD in COPD patients, MD (1.37), which showed a statistically significant result.

· The occurrence of adverse events in COPD patients treated with bisoprolol, RR (0.83), resulted in no statistical significance.

· The effect of bisoprolol on inflammatory cytokines in COPD patients, IL-6, MD (−1.16), IL-8, MD (−0.94), CRP, MD (−1.74), the results were statistically significant.

· Subgroup analysis performed of each outcome indicator according to whether the patients had heart failure or not showed that the therapeutic effect of bisoprolol on COPD did not change with the presence or absence of heart failure.

"The available evidence indicates that bisoprolol is effective and safe for the treatment of COPD patients, that this efficacy is not only effective in patients with COPD with heart failure, but also in patients without HF, and that the early bisoprolol use may have a positive prognostic impact in patients with COPD," the researchers wrote.

"Two RCTs evaluating the effect of bisoprolol on the rate of prevention and deterioration of cardiovascular events in COPD patients are ongoing, and more evidence of bisoprolol for COPD will be provided in the future," they concluded.

Reference:

Feng, Z., Zhang, L., Wang, Y., Guo, H., & Liu, J. (2023). Efficacy and Safety of Bisoprolol in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. International Journal of Chronic Obstructive Pulmonary Disease, 18, 3067-3083. https://doi.org/10.2147/COPD.S438930