Carbocysteine in the Management of Stable COPD: Are Its Antioxidant and Anti-Inflammatory Properties Clinically Relevant?

Abstract

BACKGROUND: The recent epidemiological and experimental evidence suggest possible antioxidant effect of carbocysteine in patients with chronic obstructive pulmonary disease (COPD).AIM: To assess efficacy and tolerability of carbocysteine in the management of stable COPD.METHODS: We performed an observational, non-randomized, open study (a real life study) including 87 patients with stable COPD (group B and D by combined COPD assessment) divided in two groups, examined group (EG) and control group (CG). All participants were treated with the regular treatment of the stable disease, but in the participants of the EG carbocysteine 1,500 mg daily was added to their regular treatment during the period of two months. The study protocol included completion of the COPD Assessment Test (CAT) and spirometric measurements at initial visit and at the end of the mentioned period.RESULTS: We found significantly lower mean value of the overall CAT score in the EG at the end of the study as compared to its mean value registered at initial visit (26.9 vs. 24.3; P = 0.007). In regard to certain CAT items, we found significantly lower values of the mean scores related to cough phlegm and sleep disturbances as compared to their mean scores at initial visit. In addition, the mean values of the overall CAT scores at initial visit and at the end of the study in controls were similar. In EG we found significantly higher mean value of the MEF 25-75 at the end of the study as compared to its mean value registered at initial visit (59.3% vs. 67.2%; P = 0.003). There was no significant difference in the mean values of other spirometric parameters at the end of the study as compared to their mean values at initial visit. In controls we registered similar values of all measured spirometric parameters at the end of the study as compared to their values registered at initial visit. Mild gastrointestinal manifestations were registered in 13.3% of the participants of the EG during the examined period.CONCLUSION: Our findings indicate positive effects of carbocysteine regarding the symptoms and lung function, as well as its good tolerability in the patients with stable COPD

Effects of A Long-Term Use of Carbocysteine on Frequency and Duration of Exacerbations in Patients with Bronchiectasis

“…Results of the present study indicated lower frequency and lower duration of exacerbations in the group who received carbocysteine over three months as compared to exacerbations frequency and duration in the group who did not receive carbocysteine. The majority of clinical studies of cysteine derivates have been performed in COPD, with conflicting results [15], [40], [41]. The evidence supporting the use of cysteine derivates in bronchiectasis is even more limited.…”

“…The present study aimed to assess the effects of long-term use of carbocysteine on incidence and duration of exacerbations in patients with bronchiectasis. This study is a continuum of our investigating the effects of carbocysteine in the treatment of lung diseases characterised by excessive production of viscous mucus [14], [15].…”

Mucoactive Agents in the Therapy of Upper Respiratory Airways Infections: Fair to Describe Them Just as Mucoactive?

“…50 Radical scavenging activities have also been reported. 51 Although recent, specific reviews exist for ambroxol, 15 bromhexine, 23 NAC and carbocysteine, 38,52,53 and erdosteine, 44,45,54,55 sobrerol has not received much attention, probably because most studies have been published in Italian and often in difficult-to-access journals. Only 1 old, outdated review on sobrerol has so far been published.…”