Efficacy of Erdosteine for Preventing Acute Exacerbation in Chronic Obstructive Pulmonary Disease

Abstract

An acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an acute worsening of symptoms needing additional treatment or change of treatment. It is a major problem for COPD patients as it can lead to death if not treated promptly. Therefore, in addition to treatment according to stages or severity of the disease in patients with stable COPD, the treatment in the event of AECOPD and the prevention of recurrence of AECOPD must also be taken into account. Prevention of AECOPD and reduction of mortality, in addition to reducing current symptoms, are other main treatment goals according to the Global Initiative for Obstructive Lung Disease (GOLD) guideline. The 2021 GOLD guideline stated that erdosteine, a class of mucoregulators or mucolytics, has been shown to be effective in preventing AECOPD similar to N-acetylcysteine and carbocysteine. It has additional properties from other drugs in the same group. Besides its mucolytic activity, it also has properties as an antioxidant, anti-inflammatory, antibacterial agent, and can enhance the effect of antibiotics when administered concurrently. It was found that long-term dosing of 300 mg 2-3 times a day was able to significantly reduce the number of AECOPD incidents, and reduce the duration of hospitalization. The most common adverse reactions were gastrointestinal disorders including nausea, vomiting, diarrhea, altered taste, neurological symptoms, headache and respiratory tract infections. However, patients tolerated adverse drug reactions well. Therefore, erdosteine ​​may be considered for use in mild and moderate to severe COPD patients with a history of frequent AECOPD as adjunctive therapy to main AECOPD prophylactic treatment.