Summary
Metoprolol has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. ClinicalTrials.gov lists 7 registered trials linking Metoprolol to COPD: 2 are active or not yet recruiting; 2 have completed; 3 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT03566667). It plans or enrolled 1713 participants. Registration activity spans 2004 to 2025. The literature layer holds 5 publications for this pair: 5 clinical trial publications. Publication years run from 2018 to 2024. These are primary trial reports rather than syntheses, so results have not yet been pooled or graded independently.
The RepurpOS disease-intelligence file for Chronic Obstructive Pulmonary Disease ranks 505 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: Effectively zero — airflow obstruction is irreversible by definition in COPD; FEV1 decline continues at 30-60 mL/year on standard care.
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 54.0 (trials 24.0, literature 10.0, tier 15, approved bonus 5.0) |
| Registered trials | 7 total: 0 recruiting, 2 active / not yet recruiting, 2 completed, 3 other |
| Linked publications | 5 (5 clinical trial publications) |
| Agent type | Drug (Small molecule) |
| Development stage (any indication) | Approved |
| Mechanism / class | Not recorded |
| Data sources | Open Targets, ChEMBL |
| Linked via biomarker / target | ADCY5 |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT03566667 | Beta-blockers to Patients With Chronic Obstructive Pulmonary Disease 2018 | active, not recruiting | Phase 4 | 1,713 |
| NCT03370835 | Tolerability of Metoprolol-Succinate-ER and Carvedilol in COPD 2004 | completed | Phase 4 | 21 |
| NCT06825728 | Metoprolol in Patients With HFrEF and COPD 2025 | not yet recruiting | Phase 4 | 311 |
| NCT00288548 | Metoprolol and Formoterol in Chronic Obstructive Pulmonary Disease (COPD) 2006 | status unknown | Phase 4 | 45 |
| NCT00384566 | A Comparison of the Effect of Carvedilol and Metoprolol on Airways Tone in Patients With Heart Failure 2005 | withdrawn | Phase 4 | — |
| NCT02587351 | Beta-Blockers for the Prevention of Acute Exacerbations of Chronic Obstructive Pulmonary Disease 2016 | terminated | Phase 3 | 532 |
| NCT00745043 | Beta-Blocker in Chronic Obstructive Pulmonary Disease (COPD) Study 2005 | completed | Not applicable | 11 |
Published literature
- Clinical trial publication Bisoprolol in Patients With Chronic Obstructive Pulmonary Disease at High Risk of Exacerbation: The BICS Randomized Clinical TrialDevereux G, Cotton S, Nath M et al. · JAMA · 2024 · PMID 38762800
- Clinical trial publication Association between P-pulmonale and respiratory morbidity in COPD: a secondary analysis of the BLOCK-COPD trialWade RC, Mkorombindo T, Ling SX et al. · BMC pulmonary medicine · 2023 · PMID 37946165
- Clinical trial publication Lung Function and the Risk of Exacerbation in the β-Blockers for the Prevention of Acute Exacerbations of Chronic Obstructive Pulmonary Disease TrialParekh TM, Helgeson ES, Connett J et al. · Annals of the American Thoracic Society · 2022 · PMID 35363600
- Clinical trial publication Metoprolol for the Prevention of Acute Exacerbations of COPDDransfield MT, Voelker H, Bhatt SP et al. · The New England journal of medicine · 2019 · PMID 31633896
- Clinical trial publication Relationship between heart failure, concurrent chronic obstructive pulmonary disease and beta-blocker use: a Danish nationwide cohort studySessa M, Mascolo A, Mortensen RN et al. · European journal of heart failure · 2018 · PMID 29159953
Mechanism and notes
No mechanism of action is recorded for this pair in the source databases.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL, in this case via the biomarker or target ADCY5. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Metoprolol approved for COPD?
Metoprolol has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Metoprolol in clinical trials for COPD?
ClinicalTrials.gov lists 7 registered trials linking Metoprolol to COPD: 2 are active or not yet recruiting; 2 have completed; 3 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT03566667). It plans or enrolled 1713 participants. Registration activity spans 2004 to 2025.
What does the evidence show for Metoprolol in COPD?
Metoprolol has 2 completed trials and 5 linked publications for COPD. Completed trials may or may not have posted results; follow the NCT links to check. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL, in this case via the biomarker or target ADCY5. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.