New Hope For COPD Patients In Mucolytic Carbocisteine

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Main Category: Respiratory / Asthma
Also Included In: Clinical Trials / Drug Trials
Article Date: 14 Jun 2008 - 0:00 PDT

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The worsening of symptoms in patients with chronic obstructive pulmonary disease (COPD) can be curtailed by using carbocisteine, according to an article released on Jun 16, 2008 in The Lancet.

Carbocisteine is a mucolytic drug, which breaks down mucus in the body so that it can be more easily cleared from the body. Since one of COPD's symptoms involves the oversecretion of mucus, mucolytics have great potential for treatment of this disease. Additional characteristics of COPD include airflow limitation, oxidative stress, and airway inflammation.

To investigate the potential of carbocisteine in COPD treatment, Dr Nan-Shang Zhong, of the Gangzhou Institute of Respiratory Disease, China, and colleagues performed a randomized, controlled study, called the PEACE trial, examining yearly exacerbation rates in patients with COPD.

They examined 709 patients, between 40 and 80 years old, with COPD from 22 centers in China. Each patient had a history in the previous two years of two or more COPD exacerbations, in which symptoms worsened consistently for at least two days. However, each patient was also clinically stable in the four weeks before the study.

The patients were randomly assigned to receive either 1,500 mg carbociseine (354 patients) or a placebo (355 patients) every day for a year. The number of exacerbation events were much lower in the group taking the carbociseine group in comparison, indicating a 25% risk reduction in the test population.

The authors conclude that the potential for mucolytics is still great: Mucolytics, such as carbocisteine should be recognised as a worthwhile treatment for prevention of exacerbations in Chinese patients with COPD." They note that this treatment is much cheaper than other options and could thus be especially useful in treating COPD in developing countries.

Dr Paul Albert and Professor Peter Calverley, of the University of Liverpool, UK, contributed an accompanying comment in which they inquire: could the findings of this trial be applied to patients who are not of Chinese origin? "What is clear from PEACE is the rigorous clinical trials of existing drugs can offer new insights into COPD care."

Effect of carbocisteine on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo-controlled study
Jin-Ping Zheng, Jian Kang, Shao-Guang Huang, Ping Chen, Wan-Zen Yao, Lan Yang, Chun-Xue Bai, Chang-Zheng Wang, Chen Wang, Bao-Yuan Chen, Yi Shi, Chun-Tao Liu, Ping Chen, Qiang Li, Zhen-Shan Wang, Yi-Jiang Huang, Zhi-Yang Luo, Fei-Peng Chen, Jian-Zhang Yuan, Ben-Tong Yuan, Hui-Ping Qian, Rong-Chang Zhi, Nan-Shan Zhong
Lancet 2008; 371: 2013-18
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A PEACE-ful solution to COPD exacerbations?
Paul Albert, Peter Calverley
Lancet 2008; 371: 1975-76
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Written by Anna Sophia McKenney
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