An updated insight into the effect of β-adrenergic receptor antagonists (β-blockers) on respiratory function in asthma patients: a systematic review and meta-analysis
BackgroundThis study aimed to provide an updated assessment of the changes in respiratory function after β-adrenergic receptor antagonists (β-blockers) administration in asthma patients. The main assumption of the study was to use new methodological and statistical approaches not previously applied...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2025.1582740/full |
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| author | Monika Marko Rafał Pawliczak |
| author_facet | Monika Marko Rafał Pawliczak |
| author_sort | Monika Marko |
| collection | DOAJ |
| description | BackgroundThis study aimed to provide an updated assessment of the changes in respiratory function after β-adrenergic receptor antagonists (β-blockers) administration in asthma patients. The main assumption of the study was to use new methodological and statistical approaches not previously applied in this field in systematic reviews and meta-analyses.MethodsTo select studies, PubMed/Medline, Embase, ClinicalTrials.gov, and Cochrane Library were searched. Additionally, Google Scholar was searched for gray literature. A systematic review and meta-analysis for forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate in asthma patients after administration of cardio-selective and non-selective β-blockers compared to placebo or baseline was performed. We also assessed FEV1 after topical β-blocker application compared to baseline.ResultsAn independent subgroup analysis demonstrated significantly higher FEV1 in the placebo group (standardized mean difference [SMD] =−0.74, 95% confidence interval [CI]: 1.15, −0.34, P = 0.0003) than in non-selective β-blockers. The test for subgroup differences indicates that there is a statistically significant subgroup effect among cardio-selective and non-selective β-blockers (P = 0.03, I2 = 80%). We also showed a statistically significant decrease in FEV1 (SMD = −0.70, 95% CI: [−1.56 to −0.03], P = 0.04) after topical β-blocker application.ConclusionPatients with asthma may tolerate cardio-selective β-blockers better than non-selective β-blockers. The FEV1 value depends on the type of β-blocker used. Cardio-selective β-blockers may be cautiously considered in patients with asthma only when strong cardiovascular indications exist (such as heart failure with reduced ejection fraction or post-myocardial infarction) and with appropriate monitoring. At the same time, less risky therapeutic options should be chosen instead of topical β-blockers.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier 42024606876. |
| format | Article |
| id | doaj-art-2eede150a9be49b2967a3e79ba7ba144 |
| institution | Kabale University |
| issn | 1664-042X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Physiology |
| spelling | doaj-art-2eede150a9be49b2967a3e79ba7ba1442025-08-20T03:36:12ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-07-011610.3389/fphys.2025.15827401582740An updated insight into the effect of β-adrenergic receptor antagonists (β-blockers) on respiratory function in asthma patients: a systematic review and meta-analysisMonika MarkoRafał PawliczakBackgroundThis study aimed to provide an updated assessment of the changes in respiratory function after β-adrenergic receptor antagonists (β-blockers) administration in asthma patients. The main assumption of the study was to use new methodological and statistical approaches not previously applied in this field in systematic reviews and meta-analyses.MethodsTo select studies, PubMed/Medline, Embase, ClinicalTrials.gov, and Cochrane Library were searched. Additionally, Google Scholar was searched for gray literature. A systematic review and meta-analysis for forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate in asthma patients after administration of cardio-selective and non-selective β-blockers compared to placebo or baseline was performed. We also assessed FEV1 after topical β-blocker application compared to baseline.ResultsAn independent subgroup analysis demonstrated significantly higher FEV1 in the placebo group (standardized mean difference [SMD] =−0.74, 95% confidence interval [CI]: 1.15, −0.34, P = 0.0003) than in non-selective β-blockers. The test for subgroup differences indicates that there is a statistically significant subgroup effect among cardio-selective and non-selective β-blockers (P = 0.03, I2 = 80%). We also showed a statistically significant decrease in FEV1 (SMD = −0.70, 95% CI: [−1.56 to −0.03], P = 0.04) after topical β-blocker application.ConclusionPatients with asthma may tolerate cardio-selective β-blockers better than non-selective β-blockers. The FEV1 value depends on the type of β-blocker used. Cardio-selective β-blockers may be cautiously considered in patients with asthma only when strong cardiovascular indications exist (such as heart failure with reduced ejection fraction or post-myocardial infarction) and with appropriate monitoring. At the same time, less risky therapeutic options should be chosen instead of topical β-blockers.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier 42024606876.https://www.frontiersin.org/articles/10.3389/fphys.2025.1582740/fullasthmabeta-blockerscardio-selectiveFEV1non-selectivePEFR |
| spellingShingle | Monika Marko Rafał Pawliczak An updated insight into the effect of β-adrenergic receptor antagonists (β-blockers) on respiratory function in asthma patients: a systematic review and meta-analysis Frontiers in Physiology asthma beta-blockers cardio-selective FEV1 non-selective PEFR |
| title | An updated insight into the effect of β-adrenergic receptor antagonists (β-blockers) on respiratory function in asthma patients: a systematic review and meta-analysis |
| title_full | An updated insight into the effect of β-adrenergic receptor antagonists (β-blockers) on respiratory function in asthma patients: a systematic review and meta-analysis |
| title_fullStr | An updated insight into the effect of β-adrenergic receptor antagonists (β-blockers) on respiratory function in asthma patients: a systematic review and meta-analysis |
| title_full_unstemmed | An updated insight into the effect of β-adrenergic receptor antagonists (β-blockers) on respiratory function in asthma patients: a systematic review and meta-analysis |
| title_short | An updated insight into the effect of β-adrenergic receptor antagonists (β-blockers) on respiratory function in asthma patients: a systematic review and meta-analysis |
| title_sort | updated insight into the effect of β adrenergic receptor antagonists β blockers on respiratory function in asthma patients a systematic review and meta analysis |
| topic | asthma beta-blockers cardio-selective FEV1 non-selective PEFR |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2025.1582740/full |
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