An overview of the efficacy and safety of β 2 -adrenoceptor antagonists for the treatment of chronic obstructive pulmonary disease

Introduction: The safety of beta(2)-AR antagonists in the treatment of patients with COPD continues to be a topic of research and discussion within the medical community. Emerging evidence suggests potentially benefits in the management of this complex respiratory condition. However, antagonists that display a preference for beta(2)-AR over beta(1)-AR present a complex therapeutic challenge in COPD management, necessitating an understanding of differences in their pharmacological profiles and clinical implications. Areas covered: An overview of the mechanisms of action of beta(2)-AR antagonists and their potential impact on respiratory function, their pharmacological interactions, clinical implications, and future perspectives in COPD. Expert opinion: beta-Blockers have the potential to become a versatile class of therapeutic agents with benefits beyond their original cardiovascular use. However, the one-size-fits-all approach of prescribing beta-blockers regardless of their receptor selectivity to COPD patients with concomitant heart disease may not be appropriate. Instead, it is advisable to develop an individualized treatment strategy based on a thorough assessment of the patient's overall health. The use of non selective beta(2)-AR antagonists, functioning as inverse agonists at beta(2)-ARs, has garnered interest and debate, but further research efforts should focus on elucidating the optimal use of beta-AR antagonists in COPD, balancing cardiovascular benefits with potential respiratory risks to enhance outcomes and quality of life for individuals living with this debilitating respiratory condition.