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Collaborative Systematic Overview of Randomised Controlled Trials of Beta-Blockers in the Treatment of Heart Failure (BB-META-HF)

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ClinicalTrials.gov Identifier: NCT00832442
Recruitment Status : Unknown
Verified January 2009 by Royal Brompton & Harefield NHS Foundation Trust.
Recruitment status was:  Enrolling by invitation
First Posted : January 30, 2009
Last Update Posted : May 9, 2012
Sponsor:
Collaborator:
University of Oxford
Information provided by (Responsible Party):
Royal Brompton & Harefield NHS Foundation Trust

Study Description
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Brief Summary:

Several large trials have shown that beta-blocker treatment reduces the risk of death and hospital admission in patients with symptomatic heart failure. Unfortunately, survey data suggests relatively poor utilisation of beta-blockers, despite ample evidence for good tolerability. Additionally there are several important unanswered questions, such as clinical efficacy for specific sub-populations (women, the elderly and patients with diabetes or other co-morbidities) and the effect of beta-blockers in combination with other medications. Previous meta-analyses, based on published tabular data, have been conducted although this approach has important biases and limitations.

We plan to perform a carefully conducted systematic review of individual patient data from the major randomised trials of beta-blockers in heart failure. The goals of this collaborative project are to clarify the overall efficacy of beta-blockers and identify sub-groups that show particular benefit, thereby increasing the use of beta-blockers, reducing adverse clinical outcomes and the high costs associated with this condition.


Condition or disease Intervention/treatment
Heart Failure Drug: Beta blocker Other: Placebo

Study Design
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Study Type : Observational
Estimated Enrollment : 18240 participants
Official Title: Collaborative Systematic Overview of Randomised Controlled Trials of Beta-Blockers in the Treatment of Heart Failure
Study Start Date : August 2008
Estimated Primary Completion Date : December 2012
Estimated Study Completion Date : December 2012

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure

Groups and Cohorts
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Group/Cohort Intervention/treatment
Beta blocker Drug: Beta blocker
as determined by individual study
Other Names:
  • Metoprolol
  • Bucindolol
  • Carvedilol
  • Bisoprolol
  • Nebivolol
Placebo Other: Placebo
in addition to usual care


Outcome Measures
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Primary Outcome Measures :
  1. Beta-blocker therapy improves overall mortality and morbidity in symptomatic heart failure in an individual patient meta-analysis [ Time Frame: variable (time to event) ]

Secondary Outcome Measures :
  1. Beta-blocker therapy improves mortality and morbidity in both elderly patients and women [ Time Frame: variable (time to event) ]
  2. Beta-blocker therapy improves mortality and morbidity in patients with co-morbidities (diabetes, renal dysfunction, COPD, peripheral arterial disease or atrial fibrillation) [ Time Frame: variable (time to event) ]
  3. The benefit of beta-blockers is not modified by concomitant cardiovascular therapy [ Time Frame: variable (time to event) ]
  4. The benefit of beta-blockers is independent of left ventricular ejection fraction at baseline [ Time Frame: variable (time to event) ]
  5. The clinical benefit is dependent on the resting heart rate achieved whatever the dose achieved or agent used [ Time Frame: variable (time to event) ]
  6. Adverse side effects of beta blocker therapy do not significantly impact on clinical benefit (as a whole and in relevant sub-groups) [ Time Frame: variable (time to event) ]

Eligibility Criteria
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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Meta-Analysis of randomised controlled trials investigating mortality & morbidity of placebo versus beta-blockers in heart failure
Criteria

Inclusion Criteria:

  • Randomised control trials of beta-blocker versus control in patients with documented heart failure
  • Unconfounded trials only (in which one treatment group differed from another only by the beta-blocker therapy of interest)
  • Randomization process precluded prior knowledge of the next treatment (for example trials in which treatment allocation was alternate or based on odd or even dates would not be included)

Exclusion Criteria:

  • Trial sample size of less than 300 patients
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00832442


Locations
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United Kingdom
Clinical Trials & Evaluation Unit, Royal Brompton Hospital
London, United Kingdom
Centre for Statistics in Medicine, University of Oxford
Oxford, United Kingdom
Sponsors and Collaborators
Royal Brompton & Harefield NHS Foundation Trust
University of Oxford
Investigators
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Study Chair: Marcus Flather Royal Brompton Hospital, London
Study Chair: Luis Manzano Universidad de Alcala, Madrid
Study Chair: Dipak Kotecha Royal Brompton Hospital, London
Study Chair: Henry Krum Monash University, Melbourne
More Information
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Additional Information:

Publications:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Royal Brompton & Harefield NHS Foundation Trust
ClinicalTrials.gov Identifier: NCT00832442    
Other Study ID Numbers: CTEU08/d5/BBHF
First Posted: January 30, 2009    Key Record Dates
Last Update Posted: May 9, 2012
Last Verified: January 2009
Keywords provided by Royal Brompton & Harefield NHS Foundation Trust:
Beta blocker
Heart Failure
Meta analysis
Individual patient data
Additional relevant MeSH terms:
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Heart Failure
Heart Diseases
Cardiovascular Diseases
Metoprolol
Carvedilol
Nebivolol
Bisoprolol
Bucindolol
Adrenergic beta-Antagonists
Anti-Arrhythmia Agents
Antihypertensive Agents
Sympatholytics
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
 Adrenergic beta-1 Receptor Antagonists
Adrenergic Antagonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Antioxidants
Protective Agents
Calcium Channel Blockers
Membrane Transport Modulators
Calcium-Regulating Hormones and Agents
Vasodilator Agents
Adrenergic alpha-1 Receptor Antagonists
Adrenergic alpha-Antagonists
Adrenergic beta-1 Receptor Agonists
Adrenergic beta-Agonists