Late Breaking Abstract - The impact of regular bisoprolol on recovery with salbutamol in asthma; a double-blind randomised controlled trial

This study investigates the response after continued exposure to cs-B1B.Methods: 19 mild asthmatics completed a randomized, double-blind, placebo-controlled crossover study powered for non-inferiority of up-titrated bisoprolol to a maximum of 5mg daily against placebo. Controlled bronchoconstriction with mannitol inhalation (Aridol®) dropped the forced expiratory volume in 1 second (FEV1) by 15%. 400µg salbutamol was then given over 15 minutes. This gave a recovery curve of FEV1 over time, the primary endpoint was area under this curve, (AUC, L/min). Open label extension went up to 10mg bisoprolol daily (n=13). Undertaken in accordance with the declaration of Helsinki.Results: Paired t-test showed the difference on AUC of recovery with salbutamol was not inferior in the bisoprolol group compared to placebo in the blinded comparison (n=19, mean (95% CI) -0.41(-2.49, 1.67), p=0.68). This was also true in the open label comparison up to 10mg bisoprolol (n=13, mean (95% CI) -0.26 (-3.07, 2.55), p=0.84).Discussion: Mild asthmatics taking regular doses of cs-B1B, bisoprolol, had preserved recovery with inhaled beta-agonist therapy following controlled bronchoconstriction compared to placebo. This adds to data supporting the safe use of cs-B1B in asthma. Inclusion of mild asthmatics in cs-B1B cardiovascular randomised control trials should be considered. Further work looking at moderate and severe asthmatics is also warranted.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research