Evidence map›Paper›PMID 33622362›Full record

SynthesisRespiratory research2021

Beta-blocker therapy in patients with COPD: a systematic literature review and meta-analysis with multiple treatment comparison.

Claudia Gulea, Rosita Zakeri, Vanessa Alderman, Alexander Morgan, Jack Ross, Jennifer K Quint

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
5.3field-weighted citation impact, top 3% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 53 citations in OpenAlex.

  1. Trial
  2. Article
  3. Observational
  4. Article
  5. Review
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  7. Review
  8. Review
  9. An approach to heart failure for the public-sector primary care clinician.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025
    Article
  10. Observational
  11. Article
  12. Article
  13. Extrapulmonary Comorbidities Associated with Chronic Obstructive Pulmonary Disease: A Review.International journal of chronic obstructive pulmonary disease · 2024
    Review
  14. Article
  15. Article
  16. Pharmacological therapy for stable chronic obstructive pulmonary disease.Chronic diseases and translational medicine · 2023
    Review
  17. Article
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 6 institutions in 2 countries.

Claudia GuleaNational Heart and Lung Institute, Imperial College London, Manresa Road, London, UK. c.gulea18@imperial.ac.uk.ORCID http://orcid.org/0000-0001-9607-5901
Rosita ZakeriBritish Heart Foundation Centre for Research Excellence, King's College London, London, UK.
Vanessa AldermanHomerton University Hospital NHS Foundation Trust, London, UK.
Alexander MorganEpsom and St. Helier University Hospitals NHS Trust, Epsom, UK.
Jack RossGuy's & St Thomas' NHS Foundation Trust, London, UK.
Jennifer K QuintNational Heart and Lung Institute, Imperial College London, Manresa Road, London, UK.
Epsom and St Helier University Hospitals NHS Trust · GBGuy's and St Thomas' NHS Foundation Trust · GBHomerton University Hospital NHS Foundation Trust · GBKing's College London · GBLung Institute · USRoyal Brompton & Harefield NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBeta-blockers are associated with reduced mortality in patients with cardiovascular disease but are often under prescribed in those with concomitant COPD, due to concerns regarding respiratory side-effects. We investigated the effects of beta-blockers on outcomes in patients with COPD and explored within-class differences between different agents.

methodsWe searched the Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medline for observational studies and randomized controlled trials (RCTs) investigating the effects of beta-blocker exposure versus no exposure or placebo, in patients with COPD, with and without cardiovascular indications. A meta-analysis was performed to assess the association of beta-blocker therapy with acute exacerbations of COPD (AECOPD), and a network meta-analysis was conducted to investigate the effects of individual beta-blockers on FEV1. Mortality, all-cause hospitalization, and quality of life outcomes were narratively synthesized.

resultsWe included 23 observational studies and 14 RCTs. In pooled observational data, beta-blocker therapy was associated with an overall reduced risk of AECOPD versus no therapy (HR 0.77, 95%CI 0.70 to 0.85). Among individual beta-blockers, only propranolol was associated with a relative reduction in FEV1 versus placebo, among 199 patients evaluated in RCTs. Narrative syntheses on mortality, all-cause hospitalization and quality of life outcomes indicated a high degree of heterogeneity in study design and patient characteristics but suggested no detrimental effects of beta-blocker therapy on these outcomes.

conclusionThe class effect of beta-blockers remains generally positive in patients with COPD. Reduced rates of AECOPD, mortality, and improved quality of life were identified in observational studies, while propranolol was the only agent associated with a deterioration of lung function in RCTs.

Indexed as

Adrenergic beta-AntagonistsDisease ProgressionHumansPulmonary Disease, Chronic ObstructiveAdrenergic beta-AntagonistsBeta-blockersCOPDNetwork meta-analysis

Identifiers

PMID33622362
PMCPMC7903749
OpenAlexW3129249603

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.