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Wiener klinische Wochenschrift

, Volume 127, Issue 7–8, pp 256–261 | Cite as

N-acetylcysteine in patients with COPD exacerbations associated with increased sputum

  • Zeynep Ayfer Aytemur
  • Aysegul Baysak
  • Ozer Ozdemir
  • Timur Köse
  • Abdullah Sayiner
original article

Summary

Background

N-acetylcysteine (NAC) has been shown not to alter the clinical outcome in chronic obstructive pulmonary disease (COPD) exacerbations. However, NAC may improve symptoms through its mucolytic effect in the subgroup of patients with increased sputum production. The aims of this study were to determine whether NAC improves symptoms and pulmonary function in patients with COPD exacerbation and increased sputum production.

Methods

This was a placebo-controlled study, where patients with severe COPD and increased sputum production, who were hospitalized for an exacerbation, were included. They were randomized to receive either NAC 200 mg tid or placebo in addition to the usual treatment.

Results

Forty-two patients were included and were equally distributed to NAC and placebo groups. The symptoms, namely, ease of sputum production and dyspnea at rest and on exertion significantly improved in both groups; but there was no difference in improvement between NAC and placebo groups (p = 0.96, 0.62, 0.31, respectively). Similarly, forced expiratory volume-one second (FEV1) and PaO2 levels improved significantly in NAC (964 ± 599–1239 ± 543 ml, p < 0.001, and 57.5 ± 14.5–70.5 ± 16.0 mmHg, p < 0.001, respectively) and placebo groups (981 ± 514–1180 ± 535 ml, p < 0.001 and 57.9 ± 14.3–68.7 ± 19.0 mmHg, p < 0.001, respectively), without any difference between the two groups (p = 0.52 and 0.57). There was no difference in the number of exacerbations during the 6-month follow-up period.

Conclusion

NAC does not have any beneficial effect on clinical outcomes in patients with severe COPD exacerbation associated with increased and/or viscous mucus production.

Keywords

Chronic obstructive pulmonary disease Exacerbation Treatment N-Acetylcysteine Mucolytic 

N-Acetylcystein bei Patienten mit Exazerbation einer COPD mit erhöhter Sputumproduktion

Zusammenfassung

Grundlagen

Es ist gezeigt worden, dass N-acetylcystein (NAC) das klinische Outcome einer COPD Exazerbation nicht verändert. NAC könnte aber die Symptome einer COPD durch seine schleimlösende Wirkung in einer Untergruppe von Patienten mit vermehrter Sputumproduktion bessern. Ziel dieser Studie war es zu prüfen, ob NAC die Symptome und die Lungenfunktion bei Patienten mit einer Exazerbation einer COPD mit vermehrter Sputumproduktion bessern kann.

Methodik

In diese Placebo-kontrollierte Studie wurden Patienten mit schwerer COPD und vermehrter Sputumproduktion, die wegen einer Exazerbation hospitalisiert worden waren, aufgenommen. Randomisiert erhielten sie zusätzlich zu ihrer Behandlung entweder 200 mg NAC 3x täglich oder Placebo.

Ergebnisse

Zweiundvierzig Patienten wurden in die Studie aufgenommen. Sie erhielten – gleich verteilt – NAC oder Placebo. Die Symptome, nämlich die Leichtigkeit der Sputumproduktion und die Atemnot in Ruhe und bei Belastung besserten sich in beiden Gruppen signifikant. Allerdings gab es zwischen den beiden Gruppen (NAC oder Placebo) keinen Unterschied in der Besserung (p = 0,96, 0,62, 0,31). Ebenso besserten sich die FEV1 und die PAO2 Werte in der NAC (964 ± 599 zu 1239 ± 543 ml, p < 0,001, und 57,5 ± 14,5 zu 70,5 ± 16,0 mmHg, p < 0,001) und in der Placebo Gruppe (981 ± 514 zu 1180 ± 535 ml, p < 0,001 und 57.9 ± 14.3 zu 68.7 ± 19.0 mmHg, p < 0,001) ohne jeglichen Unterschied innerhalb der beiden Gruppen (p = 0,52 und 0,57). Es gab auch keinen Unterschied in der Anzahl der Exazerbationen während der 6-monatigen Kontrollperiode.

Schlussfolgerung

NAC hat keine günstige Wirkung auf das klinische Outcome bei Patienten mit Exazerbation einer schweren COPD mit gesteigerter und/oder visköser Schleimproduktion.

Schlüsselwörter

Chronisch obstruktive Lungenerkrankung Exazerbation Behandlung N-Acetylcystein Schleimlösend 

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Zeynep Ayfer Aytemur
    • 1
  • Aysegul Baysak
    • 2
  • Ozer Ozdemir
    • 3
  • Timur Köse
    • 4
  • Abdullah Sayiner
    • 5
  1. 1.Department of Chest DiseasesInonu University Faculty of MedicineMalatyaTurkey
  2. 2.Department of Chest DiseasesIzmir University Faculty of MedicineIzmirTurkey
  3. 3.Siverek State HospitalSanliurfaTurkey
  4. 4.Department of Medical Informatics and BiostatisticsEge University Faculty of MedicineIzmirTurkey
  5. 5.Department of Chest DiseasesEge University Faculty of MedicineIzmirTurkey

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