Dransfield MT, Voelker H, Bhatt SP, et al. - In order to confirm the possible efficacy of beta-blockers in reducing the risk of exacerbations and death in patients with moderate or severe chronic obstructive pulmonary disease (COPD), already suggested in observational studies, researchers performed this prospective, randomized trial. They allocated patients (aged between 40 and 85 years) with COPD to receive either a beta-blocker (extended-release metoprolol) or placebo. The participants had a clinical history of COPD, as well as moderate airflow limitation and carried a heightened risk of exacerbations, as confirmed by a history of exacerbations during the past year or the prescribed use of supplemental oxygen. Cases already on a beta-blocker or with an established indication for the use of such drugs were removed. The time until the first exacerbation of COPD during the treatment duration was assessed as the primary endpoint. Findings revealed that the metoprolol group and the placebo group were similar with respect to time until the first COPD exacerbation in a sample of patients with moderate or severe COPD who did not have an established indication for beta-blocker use. Those managed with metoprolol more commonly experienced hospitalization for exacerbation.