Nebivolol (Nebilet((R))) a beta(1)-blocker of the third generation - also save for patients with obstructive lung diseases?

Twenty-four patients with bronchial hyperreactivity due to asthma (8 patien ts), COPD (13) and of unknown origin (3) entered and completed a randomized double-blind intraindividual cross-over study. Thirteen patients first rec eived the highly selective vasodilatating beta(1)-blocker Nebivolol (5 mg) and 11 patients first placebo with a wash-out period of at least 2 days. Be fore the controlled oral intake of the tablets, the patients were challenge d with increasing inhalative doses of carbachol between 8 and 9 a.m. accord ing to the recommendation of the German Society of Pneumology. At 10, 11 an d 12 a.m. and I and 2 p.m. control measurements of airway patency (R-aw, FE V1) were performed in the body box. At the same time intervals, oxygen satu ration and pulse rate (pulsoximetry) including systolic and diastolic blood pressure were monitored. From 2-3 p.m. the carbachol provocation was repea ted as in the morning to assess the changes in hyperreactivity due to Nebiv olol. Results During the Nebivolol phase, blood pressure values and pulse r ates were significantly reduced compared to the placebo phase. At the same time intervals, no significant changes of the measured body box variables t o assess airway obstruction were observed during therapy with Nebivolol com pared to placebo. Comparing the measured variables (maximal deviation from base-line values of R-aw and FEV1) during carbachol provocation in the afte rnoon under Nebivolol and placebo with the values in the morning before any medication (base-line values), there were also no significant detectable d ifferences indicating an increase of bronchial hyperreactivity under Nebivo lol treatment. Conclusion It seems that Nebivolol in these hyperreactive pa tients is as safe as placebo despite its significant effect on blood pressu re and pulse rate.