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Tolerability of Bisoprolol on Domiciliary Spirometry in COPD

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Abstract

We investigated if serial domiciliary measures of spirometry were sensitive at detecting subtle effects of beta-2 blockade associated with bisoprolol in (n = 17) patients with COPD. After a two-week run in on inhaled corticosteroid (ICS) and long acting beta-2 agonist (LABA): beclometasone/formoterol 100/6 µg, patients’ started additional a long acting muscarinic receptor antagonist: (LAMA) Tiotropium 18 µg, with concomitant weekly dose titration of bisoprolol: 1.25–2.5–5 mg. After a further week of bisoprolol 5 mg, they were stepped back down to (ICS/LABA) for one week. Mean age was 64 years, mean FEV1 52% predicted, and mean FEV1/FVC ratio of 0.46. Compared to baseline am FEV1 of 1.38 L (95% CI 1.14–1.61 L), both ICS/LABA/LAMA and ICS/LABA in conjunction with bisoprolol showed statistically significant mean falls of 100 ml (1.28 L, 95% CI 1.03–1.53 L), and 120 ml, respectively (1.26 L, 95% CI 1.01–1.51 L); equalling and exceeding the MCID of 100 ml, respectively. These changes were disconnected from symptoms, reliever use and oxygen saturation.

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Funding

The study was partially funded by TENOVUS Scotland (Grant No. T12/28) as well as from existing departmental unrestricted grant funds.

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Authors and Affiliations

  1. Scottish Centre for Respiratory Research, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, DD1 9SY, UK

    Sunny Jabbal & Brian J. Lipworth

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  1. Sunny Jabbal
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  2. Brian J. Lipworth
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Correspondence to Brian J. Lipworth.

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Conflict of interest

Dr. Jabbal reports personal fees and non-financial support from Chiesi Pharma, personal fees and non-financial support from Pfizer, non-financial support and other from Napp, personal fees and non-financial support from AstraZeneca, personal fees from Boehringer Ingelheim, non-financial support from TEVA, outside the submitted work. Dr. Lipworth reports grants, personal fees and non-financial support from Chiesi, grants, personal fees, non-financial support and other from Boerhingher Ingelheim, grants and personal fees from Meda, grants, personal fees and non-financial support from Teva, grants from Janssen, grants from AstraZeneca, grants from Roche, personal fees from Dr Reddys, personal fees from Cipla, personal fees from Lupin, personal fees from Sandoz, grants from Sanofi, outside the submitted work.

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Jabbal, S., Lipworth, B.J. Tolerability of Bisoprolol on Domiciliary Spirometry in COPD. Lung 196, 11–14 (2018). https://doi.org/10.1007/s00408-017-0061-y

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