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International COPD experts reached consensus on using mucolytic agents, like erdosteine and N-acetylcysteine (NAC), to reduce exacerbations and improve symptoms in patients with chronic obstructive pulmonary disease (COPD).

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Area of Science:

  • Pulmonary Medicine
  • Pharmacology

Background:

  • International guidelines suggest mucolytic agents for chronic obstructive pulmonary disease (COPD) to reduce exacerbations and improve health.
  • Evidence varies across mucolytic agents, necessitating expert consensus on their use.

Purpose of the Study:

  • To assess international COPD expert consensus on the use of specific mucolytic agents.
  • To evaluate carbocysteine, erdosteine, and N-acetylcysteine (NAC) for COPD management.

Main Methods:

  • Delphi method employed with 53 international COPD experts from 12 countries.
  • Online questionnaire with 15 statements rated on a 5-point scale; data collected anonymously.

Main Results:

  • Consensus reached by 47 respondents on the efficacy of mucolytics in reducing COPD exacerbation frequency and duration.
  • Erdosteine showed the highest consensus; all agents demonstrated antioxidant and anti-inflammatory effects.
  • Mucolytics considered effective for acute exacerbation symptom treatment and regular use in bronchitic COPD phenotypes with favorable side-effect profiles.

Conclusions:

  • Expert consensus supports broader use of mucolytic agents as add-on therapy for COPD.
  • Consideration of differing pharmacological actions and clinical effectiveness is crucial for selecting appropriate mucolytics.