PEACE Study:ムコダインのCOPD急性増悪予防効果

中国が果たしてPEACEな国なのかわからないが、PEACE Studyを発表

COPDに関してはこの種の薬剤は、アンチオキシダント剤としてのアセチルシステイン(ムコフィリン)くらいしかまともな臨床的エビデンスがない(GOLD 2007 Update)と思っていたが、カルボシステイン(ムコダイン)で確かめられたことは大きい。
Mucolytic (mucokinetic, mucoregulator) agents(ambroxol, erdosteine, carbocysteine, iodinated glycerol).
The regular use of mucolytics in COPD has been evaluated in a number of long-term studies with controversial results. Although a few patients with viscous sputum may benefit from mucolytics, the overall benefits
seem to be very small, and the widespread use of these agents cannot be recommended at present (Evidence D).

Antioxidant agents.
Antioxidants, in particular N-acetylcysteine,have been reported in small studies to reduce the frequency of exacerbations, leading to speculation that these medications could have a role in the treatment of patients with recurrent exacerbations (Evidence B).
However, a large randomized controlled trial found no effect of N-acetylcysteine on the frequency of exacerbations, except in patients not treated with inhaled glucocorticosteroids.

Effect of carbocisteine on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo-controlled study
The Lancet 2008; 371:2013-2018
FEV/FVC<0.7、%FEV 25%~79%
Japan Clinical Trials Registry (に登録されたトライアル
プラセボ群 355

carbositeine群は、プラセボ群 (1·01 [SE 0·06] vs 1·35 [SE 0·06])に比較して有意に年間急性悪化数を減少し、リスク比0.75(95% CI 0.62-0.92, p=0.004)



by internalmedicine | 2008-06-13 12:03 | 呼吸器系  

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