Benefit of Adding Erdosteine to Maintenance Treatment of COPD
Erdosteine is a mucoactive drug with anti-inflammatory, antioxidant, and anti-adhesive effects against bacteria, commonly used in the treatment of chronic obstructive pulmonary disease (COPD). In August 2022, another post-hoc analysis of the RESTORE study was published, evaluating the impact of its addition to COPD maintenance treatment on the incidence and severity of exacerbations and quality of life in patients with GOLD2 and GOLD3 grade bronchial obstruction.
Analyzed Data
The post-hoc analysis of the RESTORE study included COPD patients who took erdosteine at a dose of 300 mg twice daily or placebo added to their usual maintenance treatment for 12 months and had moderate (GOLD2, i.e., forced expiratory volume in one second /FEV1/ after bronchodilator administration to 50-79% predicted; n = 254) or severe bronchial obstruction (GOLD3; FEV1 after bronchodilator administration to 30-49% predicted; n = 191).
The analysis evaluated the incidence of exacerbations (defined as worsening symptoms requiring a change in regular medication or use of healthcare services) and the use of antibiotics and systemic corticosteroids over 12 months. Health-related quality of life (HRQoL) was also assessed using the SGRQ (St George's Respiratory Questionnaire) and the severity of COPD as rated by the physician and patient on a scale of 0-4, after 6 and 12 months.
Results
In the GOLD2 group, 43 out of 126 (34%) patients on erdosteine (including 7 moderate to severe exacerbations) and 62 out of 128 (48%) patients on placebo (including 14 moderate to severe exacerbations) experienced an exacerbation.
Patients with GOLD2 and moderate to severe exacerbation had a shorter duration of corticosteroid use with erdosteine than with placebo (11.4 vs. 13.3 days; p = 0.043) and a lower proportion of patients requiring antibiotic therapy (71.4 vs. 85.8%; p < 0.001).
In GOLD2 patients who experienced any exacerbation, treatment with erdosteine significantly improved quality of life according to the overall SGRQ score and subjective assessment of COPD severity by both patients and doctors compared to placebo.
No statistically significant differences were found in any parameters among GOLD3 patients between those on erdosteine and those on placebo.
Conclusion
Adding erdosteine to the usual COPD maintenance treatment in patients with moderate bronchial obstruction (GOLD2) reduces the incidence of exacerbations, shortens systemic corticosteroid therapy, and lowers the need for antibiotics. Additionally, these patients reported improved health-related quality of life and subjective alleviation of COPD symptoms when treated with erdosteine.
(zza)
Source: Calverley P. M. A., Papi A., Page C. et al. The effect of maintenance treatment with erdosteine on exacerbation treatment and health status in patients with COPD: a post-hoc analysis of the RESTORE dataset. Int J Chron Obstruct Pulmon Dis 2022 Aug 22; 17: 1909-1920, doi: 10.2147/COPD.S369804.
Did you like this article? Would you like to comment on it? Write to us. We are interested in your opinion. We will not publish it, but we will gladly answer you.
