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Beta-blockers for congestive heart failure in children
Anne-Kristina Frobel1, Martin Hulpke-Wette, Klaus G Schmidt
1Clinical Pharmacy and Pharmacotherapy, Heinrich-Heine-University , 26.22.02.21, Universitaetsstr. 1, Duesseldorf, Germany, 40225. frobel@uni-duesseldorf.de
The Cochrane Database of Systematic Reviews
|January 23, 2009
Summary
Current evidence is insufficient to recommend beta-blockers for pediatric congestive heart failure. More research with standardized methods is needed to determine appropriate use and dosing in children.
Area of Science:
- Pediatric Cardiology
- Pharmacology
Background:
- Beta-blockers are standard treatment for adult congestive heart failure (CHF).
- Pediatric CHF differs from adult CHF in characteristics, etiology, and drug clearance.
- Specific investigation of beta-blocker efficacy in children is warranted.
Purpose of the Study:
- To evaluate the effect of beta-adrenoceptor-blockers in pediatric congestive heart failure.
Main Methods:
- Searched multiple databases (CENTRAL, MEDLINE, EMBASE, LILACS) up to January 2008.
- Included randomized controlled trials on beta-blocker therapy for pediatric CHF.
- Two authors independently extracted and assessed trial data.
Main Results:
- Three trials with 203 participants were identified.
- Two small trials suggested improvement, but a larger trial found no benefit over placebo.
- Significant heterogeneity in study populations, treatments, and outcome measures prevented direct comparison.
Conclusions:
- Insufficient data exist to support or refute beta-blocker use in pediatric CHF.
- Further research in well-defined pediatric populations with standardized methods is required.
- Pharmacokinetic studies are needed for appropriate dosing in future pediatric trials.
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