Once again, a beta-blocker failed to prove beneficial in people with chronic obstructive pulmonary disease (COPD) without cardiovascular disease in a randomized trial.
In BRONCHIOLE, people randomized to metoprolol plus standard care had no fewer primary endpoint events during 1 year of follow-up (27.4% vs 29.9% with standard care alone, HR 0.87, 95% CI 0.73-1.05), according to Josefin Sundh, MD, PhD, of Örebro University in Sweden, reporting at the European Respiratory Society (ERS) Congress, held this year in Barcelona, Spain.
However, individual components of the primary composite endpoint consistently leaned in favor of the metoprolol group without reaching statistical significance:COPD exacerbations: HR 0.88 (95% CI 0.72-1.06)Cardiovascular events: HR 0.73 (95% CI 0.48-1.11)Death: HR 0.92 (95% CI 0.48-1.77)Exacerbations requiring hospitalization: HR 0.87 (95% CI 0.58-1.28)
In the metoprolol and control groups, serious adverse events occurred in 9.4% and 7.8%, respectively, and nonserious adverse events in 34.6% and 29.2%. The most commonly reported symptoms with metoprolol were fatigue (21.7%), symptoms attributed to low blood pressure (15.9%), and gastrointestinal symptoms (7.9%).
