Cardioselective beta-blockers for XXXX .

@entity1 @entity712 @entity1605 @entity101 @entity3885 @entity1030 @entity2263 @entity453 @entity6587 @entity1224
BACKGROUND: Beta-blocker therapy has a proven mortality benefit in @entity1 with @entity101 , @entity712 and @entity453 , as well as during the perioperative period. These drugs have traditionally been considered contraindicated in @entity1 with @entity1030 ( @entity1030 ). OBJECTIVES: To assess the effect of cardioselective beta-blockers on respiratory function of @entity1 with @entity1030 . SEARCH STRATEGY: A comprehensive search of EMBASE, MEDLINE and CINAHL was performed using the Cochrane Airways Group registry to identify randomised blinded controlled trials from 1966 to May 2001. The search was completed using the terms: asthma*, @entity6587 *, respiratory sounds*, wheez*, @entity3885 * or obstructive airway disease*, and adrenergic antagonist*, sympatholytic* or adrenergic receptor block*. We did not exclude trials on the basis of language. SELECTION CRITERIA: Randomised, blinded, controlled trials of single dose or longer duration that studied the effects of cardioselective beta-blockers on the forced expiratory volume in 1 second (FEV1) or symptoms in @entity1 with @entity1030 . DATA COLLECTION AND ANALYSIS: Two independent reviewers extracted data from the selected articles, reconciling differences by consensus. Two interventions studied were the administration of beta-blocker, given either as a single dose or for longer duration, and the use of @entity2263 -agonist given after the study drug. MAIN RESULTS: Eleven studies of single-dose treatment and 8 of treatment for longer duration, ranging from 2 days to 12 weeks, met selection criteria. Cardioselective beta-blockers produced no statistically significant change in FEV1 or respiratory symptoms compared to placebo, given as a single dose (Weighted Mean Difference -2.05% [95% Confidence interval, -6.05 to 1.96%]) or for longer duration ( @entity1605 .55% [95% CI, -5.94 to 0.84]), and did not significantly affect the FEV1 treatment response to @entity2263 -agonists. Exacerbations and hospitalizations were recorded in all trials, but none occurred during the periods of study, in either group. A subgroup analysis revealed no significant change in results for those @entity1 with severe chronic @entity1224 or for those with a reversible obstructive component. REVIEWER'S CONCLUSIONS: The available evidence suggests that cardioselective beta-blockers, given to @entity1 with @entity1030 do not produce a significant short-term reduction in airway function or in the incidence of @entity1030 exacerbations. However, the trials were small and of short duration. Given their demonstrated benefit in conditions such as @entity712 , @entity453 and @entity101 , cardioselective beta-blockers should be considered for @entity1 with @entity1030 , but administered with careful monitoring since data concerning long term administration and their effects during exacerbations are not available.
