Pooled data from clinical trials of patients with primary hypertension and/or angina pectoris reported no difference in adverse events between celiprolol and placebo (Figure 5).3 Additional analyses have found celiprolol to not induce clinically significant bradycardia compared to propranolol and to produce less dizziness, fatigue, and tiredness compared to atenolol—signifying an advantageous tolerability profile.23 Nonetheless, as with other β-blockers, celiprolol should not be used in patients with cardiogenic shock, decompensated heart failure, sick sinus syndrome, second- or third-degree heart block, or severe bradycardia.45 Celiprolol, unlike other β-blockers, may relax bronchial smooth muscle, rendering it theoretically safe for use in patients with pulmonary disease.45 In fact, several studies have shown celiprolol to not significantly affect respiratory function in patients with chronic obstructive lung disease46,47 or asthma.48,49 However, there have been reports of asthma and bronchospasm occurring in patients receiving celiprolol23,38 and a case of hypersensitivity pneumonitis occurring with celiprolol, which recurred upon rechallenge of the drug.50 Therefore, caution should still be exercised in patients with lung disease who are taking celiprolol, and monitoring for respiratory symptoms is still recommended even in patients without lung disease.38
vEDS is a rare genetic connective tissue disorder with life-threatening complications that include arterial dissections and ruptures, and intestinal and uterine ruptures.14 Currently, there are no FDA-approved therapies for vEDS in the United States, and physicians face the challenge of establishing an effective preventative treatment plan for their patients.18,55 Given its good tolerability and efficacy in a controlled, randomized clinical trial in preventing catastrophic vascular events and solid-organ ruptures, celiprolol may represent an agent with the ability to preemptively reduce the morbidity and mortality associated with vEDS. As such, it would represent a unique and innovative use of an agent from a class of drugs with a well-established track record of efficacy in treating other cardiovascular conditions.
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