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β-Blockers for the prevention of acute exacerbations of chronic obstructive pulmonary disease (βLOCK COPD): a randomised controlled study protocol
Bhatt, Surya P. Connett, John E. Voelker, Helen Lindberg, Sarah M. Westfall, Elizabeth Wells, J. Michael Lazarus, Stephen C. Dransfield, Mark T.
Bhatt, Surya P.
Connett, John E.
Voelker, Helen
Lindberg, Sarah M.
Westfall, Elizabeth
Wells, J. Michael
Lazarus, Stephen C.
Dransfield, Mark T.
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Journal article
Date
2016-06-07
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Thoracic Medicine and Surgery
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https://doi.org/10.1136/bmjopen-2016-012292
Abstract
Introduction: A substantial majority of chronic obstructive pulmonary disease (COPD)-related morbidity, mortality and healthcare costs are due to acute exacerbations, but existing medications have only a modest effect on reducing their frequency, even when used in combination. Observational studies suggest β-blockers may reduce the risk of COPD exacerbations; thus, we will conduct a randomised, placebo-controlled trial to definitively assess the impact of metoprolol succinate on the rate of COPD exacerbations. Methods and analyses: This is a multicentre, placebo-controlled, double-blind, prospective randomised trial that will enrol 1028 patients with at least moderately severe COPD over a 3-year period. Participants with at least moderate COPD will be randomised in a 1:1 fashion to receive metoprolol or placebo; the cohort will be enriched for patients at high risk for exacerbations. Patients will be screened and then randomised over a 2-week period and will then undergo a dose titration period for the following 6 weeks. Thereafter, patients will be followed for 42 additional weeks on their target dose of metoprolol or placebo followed by a 4-week washout period. The primary end point is time to first occurrence of an acute exacerbation during the treatment period. Secondary end points include rates and severity of COPD exacerbations; rate of major cardiovascular events; all-cause mortality; lung function (forced expiratory volume in 1 s (FEV1)); dyspnoea; quality of life; exercise capacity; markers of cardiac stretch (pro-NT brain natriuretic peptide) and systemic inflammation (high-sensitivity C reactive protein and fibrinogen). Analyses will be performed on an intent-to-treat basis.
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Bhatt SP, Connett JE, Voelker H, et alβ-Blockers for the prevention of acute exacerbations of chronic obstructive pulmonary disease (βLOCK COPD): a randomised controlled study protocolBMJ Open 2016;6:e012292. doi: 10.1136/bmjopen-2016-012292
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BMJ Publishing Group
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BMJ Open, Vol. 6
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