Efficacy and Safety of Bisoprolol in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Figures & data

Table 1 Characteristics of All Studies Included in Meta-Analysis

Author Year	Methods	Intervention		Sample Size		Mean Age(Years)		Duration	Outcomes
		Treatment	Control	Treatment	Control	Treatment	Control
Lv ZY 2022^Citation26	RCT	Bisoprolol	Usual care	60	60	69.65±3.35	70.75±3.25	8W	②③④⑨
Wu YM 2020^Citation27	RCT	Bisoprolol	Usual care	32	33	64.25±8.26	64.89±9.39	14D	②③④⑤⑨
Liu GY 2019^Citation28	RCT	Bisoprolol	Usual care	45	45	69.83±3.62	70.12±3.59	6M	①④⑨
Lv CX 2019^Citation29	RCT	Bisoprolol	Usual care	44	44	62.7±2.1	62.3±2.6	6W	②③⑤⑥⑦
Zeng JW 2019^Citation30	RCT	Bisoprolol	Usual care	30	30	65.68±2.71	65.21±2.78	6M	②③⑨
Yang LP 2019^Citation31	RCT	Bisoprolol	Usual care	49	49	85.26±1.30	85.24±1.26	4W	②③⑨
Jin Y 2019^Citation32	RCT	Bisoprolol	Carbocisteine	45	45	64.7±6.0	64.0±6.1	3M	②④⑨
Zhao MJ 2019^Citation33	RCT	Bisoprolol	Usual care	35	35	72.26±5.29	71.98±5.47	3M	①⑧
Yi SP 2018^Citation34	RCT	Bisoprolol	Usual care	49	49	61.89±6.74	61.35±6.14	1M	①②③
Yuan WS 2017^Citation35	RCT	Bisoprolol	Usual care	25	25	NA	NA	4M	①⑨
Yang H 2017^Citation36	RCT	Bisoprolol	Usual care	60	60	NA	NA	6M	①④⑤⑥⑦⑨
Wu B 2017^Citation37	RCT	Bisoprolol	Carbocisteine	60	60	62.6±2.3	61.3±2.1	6M	②⑤⑥⑦
Ma L 2017^Citation38	RCT	Bisoprolol	Usual care	40	40	58.7±9.6	59.2±9.4	24W	②③④
Zhou H 2017^Citation39	RCT	Bisoprolol	Usual care	53	53	56±12	54±11	3M	②③④
Cai BQ 2017^Citation40	RCT	Bisoprolol	Carbocisteine	49	49	56.5±7.6	57.0±6.9	3M	①④⑧
Hu ML 2016^Citation41	RCT	Bisoprolol	Carbocisteine	82	82	59.4±8.8	60.1±8.8	12W	⑤⑧
Wang Y 2016^Citation42	RCT	Bisoprolol	Carbocisteine	60	60	62.1±5.6	62.1±5.6	12W	①②④⑥⑦
Yang DL 2016^Citation43	RCT	Bisoprolol	Carbocisteine	83	83	59.0±8.5	60.4±8.7	3M	①②④⑤⑥⑦⑧⑨
Hong SD 2016^Citation44	RCT	Bisoprolol	Usual care	43	43	80.6±3.9	80.5±3.6	6M	①⑨
Zhou ZH 2016^Citation45	RCT	Bisoprolol	Usual care	42	42	83.75±2.32	83.26±2.24	NA	①
Hu X 2016^Citation46	RCT	Bisoprolol	Carbocisteine	50	50	63. 4 ± 1. 8	63. 2 ± 1. 6	6M	②⑤
Jiang X 2016^Citation47	RCT	Bisoprolol	Usual care	52	52	65.8±7.4	65.4±7.7	3M	①②④
Fang Y 2015^Citation48	RCT	Bisoprolol	Usual care	25	25	85.1±2.3	87.6±3.1	5M	①
Xiong JM 2015^Citation49	RCT	Bisoprolol	Usual care	51	52	65.2±7.5	67.5±7.9	8W	①②④⑥⑦⑨
Du JW 2015^Citation50	RCT	Bisoprolol	Carbocisteine	72	72	59.7±8.7	60.3±8.3	12W	⑤⑨
Li X 2015^Citation51	RCT	Bisoprolol	Carbocisteine	61	61	NA	NA	1M	②⑤
Peng HS 2015^Citation52	RCT	Bisoprolol	Usual care	80	80	NA	NA	10M	②③④⑧
Zhang GF2014^Citation53	RCT	Bisoprolol	Usual care	24	24	66.19±5.80	66.17±5.26	16W	⑨
Yuan WS 2012^Citation54	RCT	Bisoprolol	Usual care	29	29	66.37±5.32	64.37±4.28	12W	①④⑧
Zhang LN2012^Citation55	RCT	Bisoprolol	Carbocisteine	59	35	61.3±9.2	60.8±10.3	1M	②⑤
Yu Y 2011^Citation56	RCT	Bisoprolol	Usual care	30	30	72.33	71.66	16W	⑨
Pei Y 2007^Citation57	RCT	Bisoprolol	Usual care	30	22	53–72	50~70	1Y	②
Mainguy V2012^Citation58	RCT	Bisoprolol	Placebo	27	27	NA	NA	14D	②③
Hawkins NM2009^Citation59	RCT	Bisoprolol	Placebo	14	13	72.8 ± 7.4	68.7 ± 10.6	4M	②
Ke YY 2016^Citation60	RCT	Bisoprolol	Usual care	60	60	63.2(45–77)	65.7(41–83)	3M	②

Notes: Outcomes:①FEV₁%②FEV₁③FVC④ FEV₁/FVC ⑤CRP ⑥ IL-6 ⑦IL-8⑧6WMN⑨adverse events.

Abbreviations: RCT, randomized controlled trial; NA, not applicable; Y, year; M, month; W, week; D, day.

Figure 1 PRISMA (preferred reporting items for systematic reviews and meta-analysis) flow diagram.

Notes: PRISMA figure adapted from Page MJ, Moher D, Bossuyt PM et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372. Creative Commons.²⁷

Figure 2 Forest plot of FEV₁, subgroup analysis was performed according to variable of heart failure and no heart failure.

Figure 3 Funnel plot of FEV₁.

Figure 4 Forest plot of FEV₁%, subgroup analysis was performed according to variable of heart failure and no heart failure.

Figure 5 Funnel plot of FEV₁%.

Figure 6 Forest plot of FVC, subgroup analysis was performed according to variable of heart failure and no heart failure.

Figure 7 Funnel plot of FVC.

Figure 8 Forest plot of 6-minute walking distance (6MWD), subgroup analysis was performed according to variable of heart failure and no heart failure.

Figure 9 Forest plot of adverse events, subgroup analysis was performed according to variable of heart failure and no heart failure.

Figure 10 Forest plot of IL-6, subgroup analysis was performed according to variable of heart failure and no heart failure.

Figure 11 Forest plot of IL-8, subgroup analysis was performed according to variable of heart failure and no heart failure.

Figure 12 Forest plot of CRP, subgroup analysis was performed according to variable of heart failure and no heart failure.

Figure 13 Funnel plot of CRP.

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