Bisoprolol does not reduce exacerbations in at-risk COPD patients

For patients with chronic obstructive pulmonary disease (COPD), bisoprolol does not reduce the number of self-reported exacerbations treated with oral corticosteroids, antibiotics, or both, according to a study published May 19 in the Journal of the American Medical Association to coincide with the American Thoracic Society 2024 International Conference, held from May 17 to 22 in San Diego.

Graham Devereux, M.D., from the Liverpool School of Tropical Medicine in the United Kingdom, and colleagues examined whether bisoprolol decreased COPD exacerbations in individuals with COPD at high risk for exacerbations in a double-blind, placebo-controlled randomized clinical trial conducted in 76 sites. Patients were randomly assigned to receive bisoprolol or placebo (261 and 258, respectively).

Due to the COVID-19 pandemic, recruitment was suspended from March 16, 2020, to July 31, 2021. Primary outcome data were available for 514 of 515 patients; 72.0% continued taking the study drug. The researchers found that the primary outcome of patient-reported COPD exacerbations treated with oral corticosteroids, antibiotics, or both was 526 and 513 in the bisoprolol and placebo groups, respectively, with mean exacerbation rates of 2.03 and 2.01/year, respectively; the adjusted incidence rate ratio was 0.97 (95% confidence interval, 0.84 to 1.13; P = 0.72). Serious adverse events occurred in 14.5 and 14.3% of 255 and 251 patients in the bisoprolol and placebo groups, respectively (relative risk, 1.01; 95% confidence interval, 0.62 to 1.66; P = 0.96).

"Bisoprolol compared with placebo did not decrease the number of self-reported exacerbations treated with oral corticosteroids, antibiotics, or both at 52 weeks of follow-up," the authors write.

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