Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterised by progressive airflow limitation. It affects approximately 1.2 million people in the UK, is the fifth leading cause of death in the UK and costs the NHS approximately £1 billion annually.  Exacerbations of COPD account for 60% of NHS COPD costs and are associated with accelerated rate of lung function decline, reduced physical activity, reduced quality of life, increased mortality and increased risk of comorbidities such as acute myocardial infarction and stroke.  


Observational studies consistently report that beta-blocker use in people with COPD is associated with a reduced risk of COPD exacerbations. This beneficial association with exacerbations extends to people with COPD without cardiovascular disease and appears to be class specific. This pragmatic prospective double blind randomised trial will formally test whether a beta-blocker reduces the incidence of exacerbations in people with COPD.


The BICS trial, funded by the NIHR HTA programme, is a national multi-centre randomised controlled trial which aims to determine the clinical effectiveness and cost-effectiveness of adding bisoprolol (maximal dose 5mg once a day, or maximum tolerated dose) to usual COPD therapies in patients with COPD at high risk of exacerbation.


1574 participants will be recruited, half from primary care.  Patients will be randomised to bisoprolol or placebo for one year.  The primary clinical outcome is the number of participant reported COPD exacerbations necessitating a change in management (minimum change treatment with antibiotics and/or oral corticosteroids) during the one year treatment period.  


The BICS study is led by Professor Graham Devereux (University of Aberdeen/Liverpool School of Tropical Medicine) and Professor Brian Lipworth (University of Dundee).  BICS opened to recruitment in September 2018.


For more information please see the BICS Study Website



Seonaidh Cotton; 

Karen Campbell;


Data Collection - Recruitment