Department of Respiratory Epidemiology, National Heart and Lung Institute, Imperial College London, London, UK.
Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
BMJ Open. 2018 Nov 13;8(11):e024736. doi: 10.1136/bmjopen-2018-024736.
Patients with chronic obstructive pulmonary disease (COPD) who have a clinical indication for beta-blocker therapy, are often not prescribed such medication, despite evidence suggesting that beta-blockers are not associated with adverse respiratory outcomes. The primary objective of this systematic review and meta-analysis is to examine the class effect of beta-blocker use in patients with COPD. We will focus on a broad range of endpoints including, clinical, safety, and patient-centric outcomes such as health related quality of life (HRQoL) and functional capacity. A secondary objective is to explore potential within-class variation in the effects of beta-blockers among patients with COPD, and rank individual agents according to their relative benefit(s).
MEDLINE, Embase, The Cochrane Library and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases will be systematically searched, from inception to present, to identify randomised controlled trials (RCTs) and other prospective and interventional studies of beta-blocker use in patients with COPD which report on the outcomes of interest. Relative treatment effects with respect to mortality, COPD exacerbations, all-cause hospitalisation, lung function, HRQoL and exercise capacity will be summarised by meta-analysis. Individual treatments (agents) will be compared in a Bayesian network meta-analysis including RCT and observational data, if feasible.
The results of the study will be submitted for publication in a peer-reviewed journal. Only previously published aggregate data will be used for the purpose of this review.
CRD42018098983.
患有慢性阻塞性肺疾病（COPD）且有β受体阻滞剂治疗临床指征的患者，通常并未接受此类药物治疗，尽管有证据表明β受体阻滞剂与不良呼吸结局无关。本系统评价和荟萃分析的主要目的是研究 COPD 患者使用β受体阻滞剂的类效应。我们将重点关注广泛的终点，包括临床、安全性和以患者为中心的结局，如健康相关生活质量（HRQoL）和功能能力。次要目的是探索 COPD 患者中β受体阻滞剂效应的潜在类内变异性，并根据相对获益对个体药物进行排名。
将从建库开始至当前，全面检索 MEDLINE、Embase、The Cochrane Library 和 Cumulative Index to Nursing and Allied Health Literature（CINAHL）数据库，以确定报告相关结局的 COPD 患者使用β受体阻滞剂的随机对照试验（RCT）和其他前瞻性和干预性研究。将通过荟萃分析总结死亡率、COPD 加重、全因住院、肺功能、HRQoL 和运动能力等方面的相对治疗效果。如果可行，将在贝叶斯网络荟萃分析中比较个体治疗（药物），包括 RCT 和观察性数据。
研究结果将提交给同行评审期刊发表。本综述仅使用先前发表的汇总数据。
PROSPERO 注册号：CRD42018098983。
