We agree that further study of the long-term effects of ß-blockers in patients with reactive airway disease is needed. Our study demonstrated the safety of cardioselective ß-blockers in patients with mild to moderate reactive airway disease who were followed for up to 4 weeks. We believe that this study paves the way for larger, long-term trials to be done. In the meta-analysis, patients who received a single dose or continued treatment with a cardioselective ß-blocker had an increased FEV₁ response to ß-agonists compared with placebo. Furthermore, in the continued treatment trials, steroid use, asthma exacerbations, and hospitalizations did not increase.

We remind readers that the evidence for the benefit of ß-blockers in conditions such as acute myocardial infarction, coronary artery disease, diabetes mellitus, and congestive heart failure, as well as in the perioperative period, is convincing and strong. Our analysis, which pooled results from 29 randomized, controlled trials, indicated that ß-blocker use should not be withheld from patients with a history of reactive airway disease. We hope our study will encourage more widespread use of cardioselective ß-blockers in patients who could benefit from them.