Two recent Cochrane reviews report effective regimens

Papers p 1271

Exacerbations of chronic obstructive pulmonary disease affect quality of life and the cost of managing the disease. Though the long term effects of hypersecretion on the deterioration of ventilatory function in patients with chronic obstructive pulmonary disease have been debated for many years,1 recent data show a good correlation between hypersecretion and long term deterioration of ventilatory function in these patients.2 This is why mucolytics, which seem to have an effect on hypersecretory exacerbations,3 might also influence disease progression in chronic obstructive pulmonary disease. Exacerbations are important events for patients with chronic bronchitis in that they negatively affect quality of life.1 Exacerbations also have socio-economic consequences.2 Therapies aiming at reducing the occurrence and severity of exacerbations are therefore of interest.

The Cochrane review in this week's issue of the BMJ reports a meta-analysis of drugs considered to have mucolytic effects (p 1271).3 Twenty two studies of 10 drugs were included. Treated patients showed a significant reduction over controls in the number of exacerbations …