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Comparison 1 Beta‐blocker vs Placebo, Outcome 1 Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change from baseline).
Figures and Tables -
Analysis 1.1

Comparison 1 Beta‐blocker vs Placebo, Outcome 1 Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change from baseline).

Comparison 1 Beta‐blocker vs Placebo, Outcome 2 Single‐dose respiratory symptoms (Participants with symptoms, Treatment minus Placebo).
Figures and Tables -
Analysis 1.2

Comparison 1 Beta‐blocker vs Placebo, Outcome 2 Single‐dose respiratory symptoms (Participants with symptoms, Treatment minus Placebo).

Comparison 1 Beta‐blocker vs Placebo, Outcome 3 Longer duration FEV1 treatment effect (Treatment minus Placebo, % change from baseline).
Figures and Tables -
Analysis 1.3

Comparison 1 Beta‐blocker vs Placebo, Outcome 3 Longer duration FEV1 treatment effect (Treatment minus Placebo, % change from baseline).

Comparison 1 Beta‐blocker vs Placebo, Outcome 4 Longer duration respiratory symptoms (Participants with symptoms, Treatment minus Placebo).
Figures and Tables -
Analysis 1.4

Comparison 1 Beta‐blocker vs Placebo, Outcome 4 Longer duration respiratory symptoms (Participants with symptoms, Treatment minus Placebo).

Comparison 1 Beta‐blocker vs Placebo, Outcome 5 SUBGROUP: Severe COPD, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change).
Figures and Tables -
Analysis 1.5

Comparison 1 Beta‐blocker vs Placebo, Outcome 5 SUBGROUP: Severe COPD, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change).

Comparison 1 Beta‐blocker vs Placebo, Outcome 6 SUBGROUP: Severe COPD, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change).
Figures and Tables -
Analysis 1.6

Comparison 1 Beta‐blocker vs Placebo, Outcome 6 SUBGROUP: Severe COPD, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change).

Comparison 1 Beta‐blocker vs Placebo, Outcome 7 SUBGROUP: Reversible airway disease, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change).
Figures and Tables -
Analysis 1.7

Comparison 1 Beta‐blocker vs Placebo, Outcome 7 SUBGROUP: Reversible airway disease, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change).

Comparison 1 Beta‐blocker vs Placebo, Outcome 8 SUBGROUP: Reversible airway disease, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change).
Figures and Tables -
Analysis 1.8

Comparison 1 Beta‐blocker vs Placebo, Outcome 8 SUBGROUP: Reversible airway disease, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change).

Comparison 1 Beta‐blocker vs Placebo, Outcome 9 SUBGROUP: Cardiovascular conditions, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change).
Figures and Tables -
Analysis 1.9

Comparison 1 Beta‐blocker vs Placebo, Outcome 9 SUBGROUP: Cardiovascular conditions, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change).

Comparison 1 Beta‐blocker vs Placebo, Outcome 10 SUBGROUP: Cardiovascular disease, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change).
Figures and Tables -
Analysis 1.10

Comparison 1 Beta‐blocker vs Placebo, Outcome 10 SUBGROUP: Cardiovascular disease, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change).

Comparison 2 Beta‐blocker + agonist vs Placebo + agonist, Outcome 1 Single‐dose Beta‐agonist treatment effect (Treatment‐agonist effect minus Placebo‐agonist effect, % change).
Figures and Tables -
Analysis 2.1

Comparison 2 Beta‐blocker + agonist vs Placebo + agonist, Outcome 1 Single‐dose Beta‐agonist treatment effect (Treatment‐agonist effect minus Placebo‐agonist effect, % change).

Comparison 2 Beta‐blocker + agonist vs Placebo + agonist, Outcome 2 Longer duration Beta‐agonist treatment effect (Treatment‐agonist effect minus Placebo‐agonist effect,% change).
Figures and Tables -
Analysis 2.2

Comparison 2 Beta‐blocker + agonist vs Placebo + agonist, Outcome 2 Longer duration Beta‐agonist treatment effect (Treatment‐agonist effect minus Placebo‐agonist effect,% change).

Table 1. Beta‐blocker Categories

Nonselective (‐ ISA)

Nonselective (+ISA)

Selective (‐ISA)

Selective (+ ISA)

Propranolol

Oxprenolol

Atenolol

Celiprolol (+ alpha block)

Timolol

Pindolol

Metoprolol

Acebutolol

Nadolol

Dilevalol

Bisoprolol

Xamoterol

Sotolol (antiarrhythmic)

Prenalterol

Practolol

Ibutomide (+ alpha block)

Labetolol (+ alpha block)

Esmolol

Pafenolol

Tolamolol

Bevantolol (+ alpha agonist)

Figures and Tables -
Table 1. Beta‐blocker Categories
Comparison 1. Beta‐blocker vs Placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change from baseline) Show forest plot

4

108

Mean Difference (IV, Random, 95% CI)

‐2.08 [‐5.25, 1.09]

2 Single‐dose respiratory symptoms (Participants with symptoms, Treatment minus Placebo) Show forest plot

9

301

Risk Difference (M‐H, Fixed, 95% CI)

0.0 [‐0.04, 0.04]

3 Longer duration FEV1 treatment effect (Treatment minus Placebo, % change from baseline) Show forest plot

5

121

Mean Difference (IV, Random, 95% CI)

‐4.00 [‐8.09, 0.08]

4 Longer duration respiratory symptoms (Participants with symptoms, Treatment minus Placebo) Show forest plot

10

273

Risk Difference (M‐H, Fixed, 95% CI)

‐0.01 [‐0.06, 0.04]

5 SUBGROUP: Severe COPD, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change) Show forest plot

2

38

Mean Difference (IV, Random, 95% CI)

‐0.71 [‐5.69, 4.27]

6 SUBGROUP: Severe COPD, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change) Show forest plot

2

42

Mean Difference (IV, Random, 95% CI)

‐3.11 [‐8.62, 2.41]

7 SUBGROUP: Reversible airway disease, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change) Show forest plot

1

30

Mean Difference (IV, Random, 95% CI)

‐1.80 [‐7.01, 3.41]

8 SUBGROUP: Reversible airway disease, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change) Show forest plot

3

110

Mean Difference (IV, Random, 95% CI)

‐1.27 [‐6.04, 3.49]

9 SUBGROUP: Cardiovascular conditions, Single‐dose FEV1 treatment effect (Treatment minus Placebo, % change) Show forest plot

1

30

Mean Difference (IV, Random, 95% CI)

‐1.80 [‐7.01, 3.41]

10 SUBGROUP: Cardiovascular disease, Longer duration FEV1 treatment effect (Treatment minus Placebo, % change) Show forest plot

3

125

Mean Difference (IV, Random, 95% CI)

‐3.85 [‐13.37, 5.66]

Figures and Tables -
Comparison 1. Beta‐blocker vs Placebo
Comparison 2. Beta‐blocker + agonist vs Placebo + agonist

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Single‐dose Beta‐agonist treatment effect (Treatment‐agonist effect minus Placebo‐agonist effect, % change) Show forest plot

2

50

Mean Difference (IV, Random, 95% CI)

‐1.21 [‐10.97, 8.56]

2 Longer duration Beta‐agonist treatment effect (Treatment‐agonist effect minus Placebo‐agonist effect,% change) Show forest plot

3

89

Mean Difference (IV, Random, 95% CI)

‐0.70 [‐5.02, 3.63]

Figures and Tables -
Comparison 2. Beta‐blocker + agonist vs Placebo + agonist