Once-daily nebivolol 5mg does not reduce airway patency in patients with chronic obstructive pulmonary disease and arterial hypertension - A placebo-controlled crossover study

Objective: To evaluate the 24-hour time-course of the effects of a single dose of nebivolol 5mg on airway patency in patients with chronic obstructive pulmonary disease (COPD). Design: Short-term, randomised, double-blind, placebo-controlled, crossover study. Patients: 12 ex-smokers (five males; mean age 63.8 +/- 9.8 years, range 46 to 75 years) with stable COPD [mean baseline forced expiratory volume in I second (FEV1) 54.9 +/- 11.9%; change in FEV1 after salbutamol 200mug = +6.0 +/- 3.8% of baseline value] and WHO stage 1-2 mild to moderate arterial hypertension [mean baseline systolic (SBP) and diastolic (DBP) blood pressure, 150.0 +/- 2.1 and 97.9 +/- 8.4mm Hg, respectively]. Main outcome measures and results: The measured variables were lung function [vital capacity (VC), FEV1, forced vital capacity (FVC), peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF) and specific airway resistance (SRaw)], SBP/DBP and heart rate at baseline (t0), and at 1 (t1), 3 (t3), 6 (t6), 12 (t12) and 24 (t24) hours after the administration of nebivolol or placebo. Exhaled nitric oxide (e-NO) was also assayed at t0, t6 and t24. ANOVA showed that none of the changes from baseline during either 24-hour monitoring period was significant. In terms of the non-respiratory variables, nebivolol did not significantly improve SBP or DBP, although there was a trend towards a reduction in both: the difference in the change in DBP over time between the two treatments was of borderline significance (ANOVA, p < 0.06). Heart rate remained unchanged during both treatments. No significant changes in e-NO were observed throughout the study between placebo and nebivolol treatment. Conclusions: Our results suggest that a single efficacious dose of nebivolol does not affect airway patency in hypertensive patients with COPD, and seem to confirm the broad tolerability margin of this drug in patients with COPD.