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Oral Mucolytic Drugs Help with COPD
Experts disagree about which therapies can help to reduce the frequent exacerbations seen with chronic bronchitis and chronic obstructive pulmonary disease (COPD). New Zealand investigators conducted this systematic review of the efficacy of oral mucolytic agents (e.g., acetylcysteine) in modifying the natural history of these conditions.
A total of 23 randomized controlled trials, involving 4143 outpatients, were identified. The rate of exacerbations was significantly lower in patients taking oral mucolytics than in control patients (2.7 vs. 1.9 per patient per year); the number needed to treat for 1 subject to have no exacerbations was 6. Mean days of illness per month were reduced by 0.56, and mean days taking antibiotics per month by 0.53; both differences were significant. There were no significant differences between the 2 groups in lung function or adverse events.
Comment: In an accompanying editorial, it is suggested that the apparent beneficial effect of oral mucolytic agents may be explained by their ability to reduce hypersecretion and, possibly, bacterial counts. However, the authors of the review caution that these drugs may not be cost-effective in all patients with COPD and might be of more benefit in patients with severe disease or frequent exacerbations.
— KI Marton
Published in Journal Watch General Medicine June 26, 2001
Citation(s):
Poole PJ and Black PN. Oral mucolytic drugs for exacerbations of chronic obstructive pulmonary disease: Systematic review. BMJ 2001 May 26 322 1271-1274.
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- Medline abstract (Free)
Ekberg-Jansson A et al. Preventing exacerbations of chronic bronchitis and COPD. BMJ 2001 May 26 322 1259-1261.
- Original article (Subscription may be required)
- Medline abstract (Free)