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Mucoactive therapy in COPD

M. Decramer, W. Janssens
European Respiratory Review 2010 19: 134-140; DOI: 10.1183/09059180.00003610
M. Decramer
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W. Janssens
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  • FIGURE 1.
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    FIGURE 1.

    Flow chart showing of the number of studies incorporated in the Cochrane review. COPD: chronic obstructive pulmonary disease. #: <4% of the original number identified.

  • FIGURE 2.
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    FIGURE 2.

    Forest plot comparison of mucolytics versus placebo for the number of exacerbations per patient per month. Heterogenetity: Chi-squared 138.08; degrees of freedom 20 (p<0.00001); I2 96%. Test for overall effect: z-score 10.06 (p<0.000001). IV: linear instrumental variable regression. Reproduced from [23] with permission from the publisher.

  • FIGURE 3.
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    FIGURE 3.

    Forest plot comparison of mucolytics versus placebo for the number of patients with no exacerbations during the study period. Heterogenetity: Chi-squared 30.56; degrees of freedom 19 (p<0.05); I2 38%. Test for overall effect: z-score 11.28 (p<0.00001). Reproduced from [23] with permission from the publisher.

  • FIGURE 4.
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    FIGURE 4.

    Kaplan–Meier plot of the probability of a) being exacerbation free or b) having more than one exacerbation at each time-point during the study. ––––: carbocysteine; - - - -: placebo. Reproduced from [53] with permission from the publisher.

Tables

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  • Table. 1—

    Patient demographics and baseline characteristics

    CarbocysteinePlacebo
    Subjects353354
    Males273 (77)282 (80)
    Age yrs65±965±9
    Duration of COPD yrs9±910±9
    Baseline spirometry
     FEV1 L1.07±0.411.12±0.43
     FEV1 % pred44±1545±15
     FVC L2.20±0.742.28±0.75
     FEV1/FVC %50±1350±13
    GOLD stages
     II167 (47)177 (50)
     III139 (39)140 (40)
     IV47 (13)37 (11)
    SGRQ total score42±1943±19
    Medications for COPD prior to study
     β2-agonist76 (22)61 (17)
     Anticholinergic agents40 (11)36 (10)
     Inhaled corticosteroids64 (18)54 (15)
     Xanthines113 (30)95 (27)
    • Data are presented as n, n (%) or mean±sd. COPD: chronic obstructive pulmonary disease; FEV1: forced expiratory volume in 1 s; % pred: % predicted; FVC: forced vital capacity; GOLD: Global Initiative for Chronic Obstructive Lung Disease; SGRQ: St George's Respiratory Questionnaire. Reproduced from [54] with permission from the publisher.

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Mucoactive therapy in COPD
M. Decramer, W. Janssens
European Respiratory Review Jun 2010, 19 (116) 134-140; DOI: 10.1183/09059180.00003610

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Mucoactive therapy in COPD
M. Decramer, W. Janssens
European Respiratory Review Jun 2010, 19 (116) 134-140; DOI: 10.1183/09059180.00003610
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  • Article
    • Abstract
    • TREATMENT OF COPD WITH MUCOLYTIC DRUGS
    • PRESUMPTIVE MECHANISMS OF ACTION
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    • Statement of interest
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