Effect of Treatment with Mucoactive Drugs on COPD Exacerbations
During 5 years of Follow-up in the Czech Republic: A Real-World
Study

J 2025

Effect of Treatment with Mucoactive Drugs on COPD Exacerbations During 5 years of Follow-up in the Czech Republic: A Real-World Study

ZATLOUKAL, Jaromir; Clive PAGE; Kristián BRAT; Michal SVOBODA; Eva VOLAKOVA et. al.

Basic information

Original name

Effect of Treatment with Mucoactive Drugs on COPD Exacerbations During 5 years of Follow-up in the Czech Republic: A Real-World Study

Authors

ZATLOUKAL, Jaromir (203 Czech Republic); Clive PAGE (826 United Kingdom of Great Britain and Northern Ireland); Kristián BRAT (703 Slovakia, belonging to the institution); Michal SVOBODA (203 Czech Republic, belonging to the institution); Eva VOLAKOVA (203 Czech Republic); Marek PLUTINSKÝ (703 Slovakia, belonging to the institution); Michal KOPECKY (203 Czech Republic) and Vladimir KOBLIZEK (203 Czech Republic)

Edition

LUNG, NEW YORK, SPRINGER, 2025, 0341-2040

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30203 Respiratory systems

Country of publisher

United States of America

Confidentiality degree

is not subject to a state or trade secret

References:

URL

Impact factor

Impact factor: 4.600 in 2023

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s00408-025-00813-7

UT WoS

001482949500001

EID Scopus

2-s2.0-105004354643

Keywords in English

Chronic obstructive pulmonary disease; Exacerbations; Mucoactive; Erdosteine; Cough

Abstract

V originále

IntroductionStudies indicate that chronic treatment with mucoactive drugs may reduce COPD exacerbation rates. This real-world, multicenter, prospective, observational study aimed to determine the effect of long-term mucoactive treatment on exacerbations in patients with COPD in the Czech Republic.Methods452 adult patients on the Czech Multicenter Research Database of COPD with post-bronchodilator FEV1 <= 60% of predicted value received standard of care and were followed up for 5 years. For the first 24 months, 81 patients received regular thiol-based mucoactive drugs (77 erdosteine, 4 N-acetylcysteine) at the discretion of the treating physician and 371 patients had no mucoactive treatment (control group). Erdosteine was fully reimbursed, and NAC was partially reimbursed for COPD patients. The annual number/rate of COPD exacerbations over 5 years was monitored.ResultsPatients receiving mucoactive treatment for 24 months had a significantly larger reduction from baseline in all exacerbations compared to the control group (- 0.61 vs - 0.18, p = 0.026; - 0.54 vs - 0.09, p = 0.007; - 0.55 vs 0.04, p = 0.005; - 0.67 vs 0.13, p = 0.002; - 0.53 vs 0.10, p = 0.019 in the first to fifth year, respectively). The reduction in moderate exacerbations was also significantly larger in those receiving mucoactive treatment versus no mucoactive treatment. The exacerbation rate was reduced to a greater extent in the subgroups with cough or with stage 3-4 COPD who received mucoactive treatment but was independent of the use of inhaled corticosteroids (ICS).ConclusionMucoactive treatment for two years reduced the number of COPD exacerbations (all, moderate) over five years of follow-up. The reduction in exacerbations was more pronounced in patients with cough or with stage 3-4 COPD but was independent of the use of ICS.

Links

LM2023049, research and development project

Name: Český národní uzel Evropské sítě infrastruktur klinického výzkumu

Investor: Ministry of Education, Youth and Sports of the CR

Cite

ZATLOUKAL, Jaromir; Clive PAGE; Kristián BRAT; Michal SVOBODA; Eva VOLAKOVA; Marek PLUTINSKÝ; Michal KOPECKY and Vladimir KOBLIZEK. Effect of Treatment with Mucoactive Drugs on COPD Exacerbations During 5 years of Follow-up in the Czech Republic: A Real-World Study. LUNG. NEW YORK: SPRINGER, 2025, vol. 203, No 1, p. 1-15. ISSN 0341-2040. Available from: https://dx.doi.org/10.1007/s00408-025-00813-7.

@article{2500939,
   author = {Zatloukal, Jaromir and Page, Clive and Brat, Kristián and Svoboda, Michal and Volakova, Eva and Plutinský, Marek and Kopecky, Michal and Koblizek, Vladimir},
   article_location = {NEW YORK},
   article_number = {1},
   doi = {http://dx.doi.org/10.1007/s00408-025-00813-7},
   keywords = {Chronic obstructive pulmonary disease; Exacerbations; Mucoactive; Erdosteine; Cough},
   language = {eng},
   issn = {0341-2040},
   journal = {LUNG},
   title = {Effect of Treatment with Mucoactive Drugs on COPD Exacerbations During 5 years of Follow-up in the Czech Republic: A Real-World Study},
   url = {https://link.springer.com/article/10.1007/s00408-025-00813-7},
   volume = {203},
   year = {2025}
}

TY  - JOUR
ID  - 2500939
AU  - Zatloukal, Jaromir - Page, Clive - Brat, Kristián - Svoboda, Michal - Volakova, Eva - Plutinský, Marek - Kopecky, Michal - Koblizek, Vladimir
PY  - 2025
TI  - Effect of Treatment with Mucoactive Drugs on COPD Exacerbations During 5 years of Follow-up in the Czech Republic: A Real-World Study
JF  - LUNG
VL  - 203
IS  - 1
SP  - 1-15
EP  - 1-15
PB  - SPRINGER
SN  - 03412040
KW  - Chronic obstructive pulmonary disease
KW  - Exacerbations
KW  - Mucoactive
KW  - Erdosteine
KW  - Cough
UR  - https://link.springer.com/article/10.1007/s00408-025-00813-7
N2  - IntroductionStudies indicate that chronic treatment with mucoactive drugs may reduce COPD exacerbation rates. This real-world, multicenter, prospective, observational study aimed to determine the effect of long-term mucoactive treatment on exacerbations in patients with COPD in the Czech Republic.Methods452 adult patients on the Czech Multicenter Research Database of COPD with post-bronchodilator FEV1 <= 60% of predicted value received standard of care and were followed up for 5 years. For the first 24 months, 81 patients received regular thiol-based mucoactive drugs (77 erdosteine, 4 N-acetylcysteine) at the discretion of the treating physician and 371 patients had no mucoactive treatment (control group). Erdosteine was fully reimbursed, and NAC was partially reimbursed for COPD patients. The annual number/rate of COPD exacerbations over 5 years was monitored.ResultsPatients receiving mucoactive treatment for 24 months had a significantly larger reduction from baseline in all exacerbations compared to the control group (- 0.61 vs - 0.18, p = 0.026; - 0.54 vs - 0.09, p = 0.007; - 0.55 vs 0.04, p = 0.005; - 0.67 vs 0.13, p = 0.002; - 0.53 vs 0.10, p = 0.019 in the first to fifth year, respectively). The reduction in moderate exacerbations was also significantly larger in those receiving mucoactive treatment versus no mucoactive treatment. The exacerbation rate was reduced to a greater extent in the subgroups with cough or with stage 3-4 COPD who received mucoactive treatment but was independent of the use of inhaled corticosteroids (ICS).ConclusionMucoactive treatment for two years reduced the number of COPD exacerbations (all, moderate) over five years of follow-up. The reduction in exacerbations was more pronounced in patients with cough or with stage 3-4 COPD but was independent of the use of ICS.
ER  -

ZATLOUKAL, Jaromir; Clive PAGE; Kristián BRAT; Michal SVOBODA; Eva VOLAKOVA; Marek PLUTINSKÝ; Michal KOPECKY and Vladimir KOBLIZEK. Effect of Treatment with Mucoactive Drugs on COPD Exacerbations During 5 years of Follow-up in the Czech Republic: A Real-World Study. \textit{LUNG}. NEW YORK: SPRINGER, 2025, vol.~203, No~1, p.~1-15. ISSN~0341-2040. Available from: https://dx.doi.org/10.1007/s00408-025-00813-7.

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