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Efecto de la carbocisteína en la exacerbación aguda de la enfermedad pulmonar obstructiva crónica (Estudio PEACE): un
Jin-Ping Zheng1, Jian Kang, Shao-Guang Huang
1Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China.
Lancet (London, England)
|June 17, 2008
Resumen
La carbocisteína redujo significativamente las exacerbaciones anuales en pacientes chinos con enfermedad pulmonar obstructiva crónica (EPOC). Este agente mucolítico ofrece una valiosa opción de tratamiento preventivo para las exacerbaciones de la EPOC.
Área de la Ciencia:
- Medicina de las vías respiratorias.
- Farmacología Farmacología.
- Los ensayos clínicos son ensayos clínicos.
Sus antecedentes:
- La enfermedad pulmonar obstructiva crónica (EPOC) implica la limitación del flujo de aire, la hipersecreción de moco, el estrés oxidativo y la inflamación.
- La carbocisteína es un agente mucolítico con propiedades antiinflamatorias y antioxidantes demostradas.
Objetivo del estudio:
- Evaluar la eficacia de la carbocisteína en la reducción de la tasa anual de exacerbaciones entre los pacientes diagnosticados con EPOC.
- Evaluar el potencial de la carbocisteína como terapia preventiva para las exacerbaciones de la EPOC.
Principales métodos:
- Se realizó un estudio aleatorizado, doble ciego, controlado con placebo durante un año con 709 pacientes con EPOC elegibles en China.
- Los pacientes recibieron diariamente 1500 mg de carbocisteína o un placebo.
- El objetivo primario fue la tasa de exacerbaciones de EPOC durante el período de estudio de 1 año, analizado por intención de tratar.
Principales resultados:
- La carbocisteína disminuyó significativamente la tasa media anual de exacerbaciones en comparación con el placebo (1,01 frente a 1,35 exacerbaciones por paciente por año, p=0,004).
- La relación de riesgo de exacerbaciones en el grupo de carbocisteína fue de 0,75 (95% IC 0,62-0,92).
- No se observaron interacciones significativas con respecto a la gravedad de la EPOC, el estado de tabaquismo o el uso concurrente de corticosteroides inhalados.
Conclusiones:
- La carbocisteína es un tratamiento bien tolerado y eficaz para prevenir las exacerbaciones en pacientes chinos con EPOC.
- Los agentes mucolíticos como la carbocisteína deben considerarse una valiosa opción terapéutica para la prevención de la exacerbación de la EPOC.
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