Effect of erdosteine on the rate and duration of COPD exacerbations: the RESTORE study

What is it about?

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and imposes a considerable burden on healthcare resources. The goals of COPD management are currently to increase the time free of disease symptoms, reduce time spent in hospital, and improve exercise tolerance, health status and quality of life. Exacerbations are an important area of COPD care due to their impact on health status and disease progression. Recent data indicate that the burden of COPD is also related to the duration of exacerbation, the length of acute exacerbations being strongly linked with morbidity, poorer health status, and hospital admissions. Moreover longer exacerbations are associated with an increased risk of a new event and accelerate the rate of decline in lung function. Erdosteine has antioxidant and anti-inflammatory properties, but also modulates bacterial adhesiveness, properties potentially of value in treatment or prevention of exacerbations. In RESTORE study 467 patients were randomized and treated for one year with erdosteine or placebo in a multicentre, multi-country study. There was a 19.4% reduction in the exacerbation rate with erdosteine treatment. The reduction in the rate of mild exacerbations was a 57.1%. Erdosteine treatment was associated with a 24.6% decrease in all exacerbation duration with a positive effect both for mild and moderate and severe exacerbations patient groups Current pharmacological treatment of COPD improves, but does not abolish, exacerbation events. In RESTORE, erdosteine, a mucoactive drug added to usual COPD maintenance therapy, reduced the absolute number of exacerbations together with the event rate and their duration over one year. The availability of a well-tolerated (placebo like safety profile) simply administered orally active treatment like erdosteine should be of value to patients who experience these troublesome episode

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