BACKGROUND: International guidelines recommend mucolytic agents as add-on therapy in selected patients with COPD because they may reduce exacerbations and improve health status. As the evidence varies among mucolytic agents, we used the Delphi method to assess consensus amongst an international panel of COPD experts on mucolytics use in COPD. METHODS: 53 COPD experts from 12 countries were asked to complete an online questionnaire and rate their agreement with 15 statements using a 5-point scale. The mucolytic agents evaluated were carbocysteine, erdosteine and N-acetylcysteine (NAC). Data were collected anonymously and consensus presented using descriptive statistics. RESULTS: The 47 respondents reached consensus on the statements. They agreed that regular treatment with mucolytic agents effectively reduces the frequency of exacerbations, reduces the duration of mild-to-moderate exacerbations, and can increase the time to first exacerbation and symptom-free time in COPD patients. Consensus was consistently highest for erdosteine. The experts agreed that all three mucolytics display antioxidant and anti-inflammatory activity. Erdosteine and NAC were thought to improve the efficacy of some classes of antibacterial drugs. All three mucolytics were considered effective for the short-term treatment of symptoms of acute exacerbations when added to other drugs. The panel agreed that approved doses of mucolytic agents have favorable side-effect profiles and can be recommended for regular use in patients with a bronchitic phenotype. CONCLUSIONS: Consensus findings support the wider use of mucolytic agents as add-on therapy for COPD. However, the differences in pharmacological actions and clinical effectiveness must be considered when deciding which mucolytic to use.
- Klíčová slova
- COPD, Consensus, Delphi study, Erdosteine, Exacerbation, Mucolytic,
- MeSH
- acetylcystein aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- chronická obstrukční plicní nemoc farmakoterapie MeSH
- expektorancia aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- internacionalita MeSH
- karbocystein aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- kombinovaná farmakoterapie MeSH
- konsensus * MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- syndrom vzplanutí nemoci * MeSH
- thiofeny aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- thioglykoláty aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- výsledek terapie MeSH
- zdravotní stav MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- acetylcystein MeSH
- erdosteine MeSH Prohlížeč
- expektorancia MeSH
- karbocystein MeSH
- thiofeny MeSH
- thioglykoláty MeSH
- MeSH
- aplikace orální MeSH
- cystein analogy a deriváty MeSH
- epitel ultrastruktura MeSH
- karbocystein aplikace a dávkování farmakologie MeSH
- králíci MeSH
- trachea ultrastruktura MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- zvířata MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- cystein MeSH
- karbocystein MeSH
