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Mucolytic drugs may benefit patients with severe pulmonary disease

Oral mucolytic drugs for exacerbations of chronic obstructive pulmonary disease: systematic review

Patients who suffer frequent, prolonged or severe recurrences of chronic bronchitis and chronic obstructive pulmonary disease (COPD) may benefit from regular use of mucolytic drugs for at least two months, according to a review in this week's BMJ.

Mucolytic drugs are thought to help to clear congestion in the chest by reducing sputum viscosity, but are not prescribed for COPD in the United Kingdom and Australasia because they are thought to be ineffective.

Researchers in New Zealand reviewed 23 trials that compared at least two months of regular oral mucolytic drugs with placebo. They found that, compared with placebo, mucolytic therapy significantly reduced the number of recurrences and days of illness per patient per month. The number of patients who had no recurrences in the study period was greater in the mucolytic group and there was no difference in lung function or in adverse events reported between treatments.

Clinicians and patients will need to judge for themselves whether the reductions are large enough to warrant daily treatment for at least three to six months a year, say the authors. Nevertheless, if these findings are confirmed, they may help to reduce the illness and healthcare costs associated with progressively severe disease, particularly in patients who have frequent or prolonged recurrences or those who are repeatedly admitted to hospital, they conclude.

Contact:

Phillippa Poole, Senior Lecturer, Department of Medicine, University of Auckland, New Zealand Email: p.poole@auckland.ac.nz

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