Researchers at the University of Alabama at Birmingham will lead a multisite study of the role of beta blockers in patients with chronic obstructive pulmonary disease, or COPD. The study is funded by an $11 million grant from the United States Department of Defense.
COPD is the third leading cause of death in the United States and is among the most costly chronic illnesses in terms of total medical spending, missed work and disability. While it is primarily a lung disease that causes difficulty in breathing, patients with COPD are also at risk for heart disease. Beta blockers, commonly used to treat heart disease, are often not used in patients who also have COPD because of safety concerns.
“Many physicians have been reluctant to prescribe beta blockers for patients who also have COPD due to concerns that they could cause constriction of the airways in the lungs, and worsen lung function,” said Mark Dransfield, M.D., associate professor in the Division of Pulmonary, Allergy and Critical Care Medicine and primary investigator of the study. “This practice continues despite the fact that the drugs are usually tolerated well in patients with COPD, and more recent data has been published suggesting that they may also reduce the risk of exacerbations.”
Exacerbations of COPD — where a patient’s symptoms acutely worsen — are commonly caused by viral or bacterial infections or by exposure to increased levels of pollution, according to Dransfield. But some can be caused or made worse by underlying cardiovascular disease. Exacerbations lead to more than 500,000 hospitalizations each year and are the major contributor to the overall costs of the disease.
| COPD is the third leading cause of death in the United States and is among the most costly chronic illnesses in terms of total medical spending, missed work and disability. |
“The objective of this study is to determine whether beta blockers can reduce the risk of acute exacerbations of COPD and whether patients can take the drug without major side effects,” said Dransfield, who is also the medical director of the UAB Lung Health Center. “If beta blockers are shown to reduce COPD exacerbations, it will provide a totally new approach to treat patients with this chronic disabling disease.”
The UAB-led study will be carried out at 14 research centers across the United States, including civilian and Veterans Affairs hospitals. Approximately 1,100 patients with at least moderately severe COPD will be enrolled and placed on either a beta blocker called metoprolol or a placebo for up to 12 months. At the end of the study, the research team will determine how well the beta blocker was tolerated and whether it reduced the risk of exacerbations in comparison to the placebo.
“This is an important research study, as a large placebo-controlled trial is needed to definitively prove that beta blockers are safe in patients with COPD and that they do in fact reduce the risk of exacerbations,” said Victor Thannickal, M.D., director of the Division of Pulmonary, Allergy and Critical Care Medicine. “We’re gratified that the DOD selected UAB, the Lung Health Center and Dr. Dransfield to take the lead role in a study that has important implications for the treatment of COPD.”
COPD is the most common lower respiratory tract disorder in the United States and recently passed stroke as the third most common cause of death in the U.S. It is most commonly caused by cigarette smoking, though exposure to dusts and toxic chemicals can also lead to the disease. COPD leads to obstruction of the airways, which in turn causes symptoms such as cough and shortness of breath. As the disease progresses, patients find it difficult to exert themselves for even simple tasks such as bathing, walking or talking on the phone.
Other sites involved in the study are: Brigham and Women’s Hospital, Weill Cornell Medical College and Columbia University, Denver Health/National Jewish Hospital, University of Maryland, University of Michigan, Northwestern University, University of Pittsburgh, Temple University, University of California-Los Angeles, University of California-San Francisco, Minnesota Veterans Affairs Hospital, Mayo Clinic and Health Partners.