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Title: Chinese Study: Carbocisteine Prevents COPD Exacerbations

"Chinese Study: Carbocisteine Prevents COPD Exacerbations"

NEW YORK -- June 16, 2008 -- A study in Chinese patients with chronic obstructive pulmonary disease (COPD) indicates that the mucolytic agent carbocisteine can help slow the worsening of COPD symptoms in patients and, therefore, should be recognised as a worthwhile treatment. The study findings are available in the June 14 issue of [The Lancet.

Nan-Shang Zhong, MD, Guangzhou Institute of Respiratory Disease, Guangzhou, China, and colleagues conducted a randomised, double-blind, placebo-controlled trial -- Preventive Effects on Acute Exacerbations of COPD With Carbocisteine (PEACE) study -- to assess whether carbocisteine could reduce the yearly exacerbation rate in patients with COPD.

The study evaluated 709 patients (aged 40-80 years) with COPD from 22 centres in China. All patients had a history of at least 2 COPD exacerbations in the previous 2 years, and all had remained clinically stable in the 4 weeks before the study.

Patients were randomised to receive either carbocisteine 1,500 mg QD (n = 354) or placebo (n = 355) for 1 year. The number of exacerbations declined significantly in the carbocisteine group compared with the placebo group (1.01 [standard error (SE) 0.06] vs 1.35 [SE 0.06]). This represented a significant 25% reduction in risk for the carbocisteine group (risk ratio 0.75; 95% confidence interval, 0.62-0.92; P = .004).

"Mucolytics, such as carbocisteine, should be recognised as a worthwhile treatment for prevention of exacerbations in Chinese patients with COPD," the authors concluded. They added that this inexpensive treatment could be vital for treating COPD in developing countries.

In an accompanying comment, Paul Albert, MD, and Professor Peter Calverley, University of Liverpool, Liverpool, United Kingdom, examined whether these findings can be applied to patients who are not of Chinese origin. "What is clear from PEACE is the rigorous clinical trials of existing drugs can offer new insights into COPD care," they said.

SOURCE: The Lancet

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