The study, “Efficacy and safety profile of mucolytic/antioxidant agents in chronic obstructive pulmonary disease: a comparative analysis across erdosteine, carbocysteine, and N-acetylcysteine,” was published in the journal Respiratory Research.
Standard treatment for COPD includes mucolytic agents, which help reduce the viscosity (thickness) of bronchial and lung secretions by breaking down mucus, improving lung function.
Studies have shown that mucolytic agents reduce the risk of acute exacerbations (a sudden worsening of COPD symptoms), and lead to an improvement in the overall health of COPD patients.
Common mucolytic agents for COPD treatment include erdosteine, carbocysteine, and N-acetylcysteine (NAC). But there have been no studies comparing the effectiveness of these mucolytic agents. Thus, there is no data to support the use of one agent over another in the treatment of COPD.
To address this issue, researchers performed a meta-analysis (CRD42016053762) to compare the efficacy and safety of 600 mg/day of erdosteine, to 1,500 mg/day of carbocysteine, and 1,200 mg/day of NAC in the treatment of COPD.
Researchers evaluated the effectiveness of these mucolytic agents on the number of acute exacerbations of COPD (AECOPD), duration of AECOPD, and rates of hospitalization because of AECOPD. Researchers also investigated the therapies’ safety by looking at the frequency of adverse events (AEs) reported.
The team analyzed data from 2,753 COPD patients, enrolled in seven clinical trials, published between 2004 and 2017.
Overall, results showed that the use of mucolytic agents was associated with a significant reduction in the risk of AECOPD.
When looking at results from particular agents, researchers found that erdosteine was the most effective, followed by carbocysteine, then NAC.
Of note, erdosteine was the only therapy that was associated with a reduction in the risk of experiencing at least one AECOPD, as well as a decrease in the risk of hospitalization due to AECOPD.
Furthermore, erdosteine and NAC, but not carbocysteine, significantly reduced the duration of AECOPD.
The AEs caused by erdosteine, carbocysteine, and NAC were all mild, and largely well-tolerated.
Based on the results, the team concluded that “the overall efficacy/safety profile of erdosteine is superior to that of both carbocysteine and NAC,” they said.
The researchers emphasized, however, that “future head-to-head studies performed on the same COPD populations are needed to definitely confirm the results of this meta-analysis.”