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Participants are randomly allocated to take either bisoprolol (maximum dose 5mg a day) or placebo (dummy drug, maximum dose 4 tablets a day) for 12 months. Time to first exacerbation of copd, as reported by the participant at 6 and 12 months. The hull airways reflux questionnaire (harq) will be used at some sites to collect data on respiratory and gastro-intestinal symptoms.

If participants do not attend for follow-up, the trialists will attempt to get information on any serious adverse events from medical records. Participants will be reviewed at 26 and 52 weeks for the collection of the following outcome data history of exacerbations, health care utilisation, disease-related quality of life status (cat), transition dyspnoea index tdi), eq-5d-5l, lung function (fev1, fvc), adverse reactions and serious adverse events. Participants who titrate up to 5mg per day will receive two further supplies, each of four bottles of 168 tablets.

At the 1, 2, 3, and 4 week reviews the presence of side effects of bisoprolol (e. Specialty respiratory disorders, primary sub-specialty chronic obstructive pulmonary disease ukcrc code disease respiratory chronic lower respiratory diseases this is a double-blind placebo-controlled trial to assess the effectiveness and cost effectiveness of adding bisoprolol (maximum dose 5 mg a day) to current therapy for chronic obstructive pulmonary disease (copd). This will be confirmed by a telephone call at the end of the 3 weeks.

Non-heart specialists are often unwilling to prescribe beta-blockers to copd patients because older beta-blockers had lung side effects. These supplies will be delivered to participants via a courier service (or other signed for delivery service) operated by a third party. If participants do not attend for follow-up, the trialists will attempt to get some information from medical records 12.

The harq will be used at some sites to collect data on respiratory and gi symptoms. Lung function (fev1, fvc) post bronchodilator measured using spirometry performed to atsers standards at the follow-up visits at 6 and 12 months 6. All-cause, respiratory and cardiac mortality obtained from medical records, supplemented with death certificates if required 8.

Patients with copd will be invited to take part in the study. These shipments will be made around week 8 and month 5 to enable continuity of supply. In addition, copd patients who take beta-blockers appear to experience fewer exacerbations. Chronic obstructive pulmonary disease (copd) is a progressive lung disease characterised by worsening airflow limitation. Bisoprolol is cheap (4pday) and, if shown to reduce the risk of copd exacerbations in a cost effective manner, it will improve the quality of life of copd patients and reduce the burden of copd on the nhs.


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Norwich, North, South and West Norfolk CCGs ... In accordance with NICE recommendations and local decision making drugs with ... Self-care is encouraged where items are available to purchase over the counter. ... 60mg. 1.5 . Chronic Bowel. Disorders. Mesalazine MR 400mg and 800mg tablets ... tablets 2.5mg and 5mg.

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Buy now Zebeta 2.5mg 60 pills in Norwich Participants who titrate up to 5mg per day will receive two further supplies, each of four bottles of 168 tablets. 1. Genetic or Enzyme Disorder: Replacement, Modifiers, Treatment. Written informed consent to pass on participants name and address to the third party distributer will be obtained. Serious adverse events, adverse reactions, as reported by the participant during the titration period and at 6 and 12 months. 60mg. Participants are followed up at 6 and 12 months to assess the number of exacerbations to collect data on side effects, healthcare use, quality of life, At the 1.
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    These shipments will be made around week 8 and month 5 to enable continuity of supply. The dose titration schedule is a conservative interpretation of the advice provided in heart failure guidelines, the smpc for bisoprolol and nhs grampian heart failure guidelines designed for use by appropriately trained nurses in primary care settings. Participants will be randomised to receive bisoprolol or identical placebo once daily for 52 weeks. Some discomfort may be felt at the time of blood taking and biopsy procedures. Following completion of the 12 month dosing period, participants will be weaned off study drug over the following 3 weeks ( tab od) in order to avoid possible rebound myocardial ischaemia.

    Sudden deteriorations in symptoms (exacerbations) are an important feature of copd as they account for 60 of nhs copd costs and they reduce life expectancy and quality of life. The hull airways reflux questionnaire (harq) will be used at some sites to collect data on respiratory and gastro-intestinal symptoms. The primary outcome measure will be the total number of exacerbations of copd necessitating changes in management (minimum management change - use of oral corticosteroids andor antibiotics) during the one year treatment period, as reported by the participant at 6 and 12 months. Participants will receive their first eight week supply (ie one bottle containing 168 tablets) of study medication (bisoprolol 1. Participants are followed up at 6 and 12 months to assess the number of exacerbations to collect data on side effects, healthcare use, quality of life, breathlessness and lung function.

    If participants do not attend for follow-up, the trialists will attempt to get some information from medical records 12. Participants allocated to placebo will undergo an identical dose-titration regime, with a final dose of 1, 2, 3 or 4 tablets a day. The primary economic outcome measure will be cost-per-qaly gained during the one year treatment period. Change in disease associated symptoms measured using the hull airways reflux questionnaire (harq) this will only be done at some recruitment sites at baseline, 6 and 12 months 13. To ensure patient safety bisoprolol will be started at the lowest possible dose of 1. Participants who meet the inclusion criteria and who agree to take part in the study will be asked to give written informed consent. Utilisation of primary or secondary healthcare for respiratory events, as reported by the participant at 6 and 12 months. A randomised, double-blind placebo controlled trial of the effectiveness of the beta-blocker bisoprolol in preventing exacerbations of chronic obstructive pulmonary disease the aim of this study is to determine the clinical effectiveness and cost effectiveness of adding bisoprolol to usual copd treatment in patients with copd. Each supply pack will contain information on interacting drugs and side effects. Health-related quality of life measured using euroqol 5d (eq-5d-5l) index at baseline, 6 and 12 months 10.

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    ISRCTN - ISRCTN10497306: Bisoprolol in COPD study

    1 day ago ... Beta-blockers are drugs widely used to treat blood pressure and ... Norfolk and Norwich University Hospital 8. ... regime (i.e. weekly increments of 1.25mg→2.5 mg→3.75mg→5mg) ... tab od) in order to avoid possible rebound myocardial ischaemia. .... Current resting (5 minutes sitting) heart rate < 60 bpm
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