Erdosteine: Reigniting a Thiol Mucolytic for Management of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major health burden globally and in India. Oxidative stress plays a pivotal role in the pathogenesis of COPD, causing mucus hypersecretion, bronchoconstriction, and accelerated lung function decline. An important class of pharmacological agents that are often less discussed are the thiol mucolytic agents, which have a two-pronged effect of serving as both a mucolytic and an antioxidant. One of these agents which has reignited interest lately is erdosteine, with recent evidence demonstrating advantages over traditionally used N-acetylcysteine. In this review, we have summarized the key available evidence for the role of erdosteine in COPD, with takeaways on its place in therapy.