Ligand bias prevents class equality among beta-blockers

Highlights • Despite known differences, β-blockers are often regarded as a single class of drugs. • In several diseases only a subset of β-blockers are therapeutically effective. • Multiple signaling pathways and ligand bias can explain differences in effectiveness. • Results of an in vitro cellular impedance assay correlates with asthma phenotypes. • Renewed classification of β-blockers into specific profiles of ligand bias is required.