Evidence map›Paper›PMID 21558357›Full record

ArticleBMJ (Clinical research ed.)2011

Effect of beta blockers in treatment of chronic obstructive pulmonary disease: a retrospective cohort study.

Philip M Short, Samuel I W Lipworth, Douglas H J Elder, Stuart Schembri, Brian J Lipworth

2 registry-linked trialsOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 96 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
96citing papers in PubMed, 5 pooled it
28.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01221480 completednot on this map

Beta-Blockers Reduce Mortality and Exacerbations When Added to Stepwise Inhaled Therapy for COPD Without Adverse Effects on Lung Function.

TypeobservationalSponsorUniversity of DundeeRan2010 to 2010Enrolled5,977ConditionsCOPD
NCT03566667 phase4completednot on this mapstarted 2018, after this paper: background citation

Beta-blockeRs tO patieNts With CHronIc Obstructive puLmonary diseasE

TypeinterventionalSponsorOle Frobert, MD, PhDRan2018 to 2026Enrolled1,713ConditionsChronic Obstructive Pulmonary DiseaseArmsMetoprolol, Standard care
3 · Its place in the literature

Who cites it

96 citing papers in PubMed, 5 syntheses or guidelines pooled it, 268 citations in OpenAlex.

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  20. Pharmacological therapy for stable chronic obstructive pulmonary disease.Chronic diseases and translational medicine · 2023
    Review

36 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Philip M ShortAsthma and Allergy Research Group, Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, University of Dundee, Dundee DD1 9SY, Scotland, UK.
Samuel I W Lipworth
Douglas H J Elder
Stuart Schembri
Brian J Lipworth
University of Dundee · GBPerth Royal Infirmary · GBUniversity of St Andrews · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine the effect of β blockers in the management of chronic obstructive pulmonary disease (COPD), assessing their effect on mortality, hospital admissions, and exacerbations of COPD when added to established treatment for COPD.

designRetrospective cohort study using a disease specific database of COPD patients (TARDIS) linked to the Scottish morbidity records of acute hospital admissions, the Tayside community pharmacy prescription records, and the General Register Office for Scotland death registry.

settingTayside, Scotland (2001-2010) Population 5977 patients aged >50 years with a diagnosis of COPD.

main outcome measuresHazard ratios for all cause mortality, emergency oral corticosteroid use, and respiratory related hospital admissions calculated through Cox proportional hazard regression after correction for influential covariates.

resultsMean follow-up was 4.35 years, mean age at diagnosis was 69.1 years, and 88% of β blockers used were cardioselective. There was a 22% overall reduction in all cause mortality with β blocker use. Furthermore, there were additive benefits of β blockers on all cause mortality at all treatment steps for COPD. Compared with controls (given only inhaled therapy with either short acting β agonists or short acting antimuscarinics), the adjusted hazard ratio for all cause mortality was 0.28 (95% CI 0.21 to 0.39) for treatment with inhaled corticosteroid, long acting β agonist, and long acting antimuscarinic plus β blocker versus 0.43 (0.38 to 0.48) without β blocker. There were similar trends showing additive benefits of β blockers in reducing oral corticosteroid use and hospital admissions due to respiratory disease. β blockers had no deleterious impact on lung function at all treatment steps when given in conjunction with either a long acting β agonist or antimuscarinic agent

conclusionsβ blockers may reduce mortality and COPD exacerbations when added to established inhaled stepwise therapy for COPD, independently of overt cardiovascular disease and cardiac drugs, and without adverse effects on pulmonary function. NCT Number: NCT01221480

Indexed as

Adrenergic beta-AntagonistsAgedEmergency TreatmentForced Expiratory VolumeHospitalizationHumansKaplan-Meier EstimateMiddle AgedMyocardial InfarctionPulmonary Disease, Chronic ObstructiveRetrospective StudiesSteroidsTreatment OutcomeVital CapacityAdrenergic beta-AntagonistsSteroids

Identifiers

PMID21558357
PMCPMC3091487
OpenAlexW2074016661

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.