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Economical evaluation
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Roberto W. Dal Negro, Claudio F. Donner
Reports of the economic convenience of antimicrobial agents provide conflicting results (49–51). Some studies emphasize the cost-effectiveness of PDE4 inhibitor roflumilast in the societal perspective (52); of erdosteine (an antioxidant mucoactive drug) in terms of reduction of exacerbation and hospitalization rates over an 8-month daily treatment (53); of α1-antitrypsine supplementation when administered in emphysema patients with α1-antitrypsine deficiency (54), and of both influenza vaccination and pneumococcal conjugate vaccination programmes, particularly in risk groups of COPD subject (55,56).
Micronutrients in Prevention and Improvement of the Standard Therapy in Hearing Disorders
Published in Kedar N. Prasad, Micronutrients in Health and Disease, 2019
Cisplatin can cause hearing loss by increasing levels of oxidative damage and pro-inflammatory cytokines in hair cells. Pretreatment with an activator of Nrf2, such as Erdosteine,180 flunarizine,181 Ebselen,182 Ginkgolide B, a major component of Ginkgo biloba,183 and phloretin184 protected hair cells (HE1-OC1) by reducing oxidative damage, pro-inflammatory cytokines, inhibiting pro-apoptotic expression, and enhancing the levels of cytoprotective enzymes, including antioxidant enzymes,
Inhalational therapies for non-cystic fibrosis bronchiectasis
Published in Anthony J. Hickey, Heidi M. Mansour, Inhalation Aerosols, 2019
Ashvini Damodaran, Dustin R. Fraidenburg, Israel Rubinstein
Agents that affect the structure or secretion of mucous glycoproteins include mucolytic, secretolytic, and proteolytic enzymes. Many oral agents have been explored and used to varying degrees in the treatment of non-CF bronchiectasis, including glucocorticoids and macrolide antibiotics, but they will not be discussed in this chapter. Of the inhaled mucolytics available, only bromhexine and erdosteine have been shown to have clinical benefit (70). In one study, bromhexine use increased ease of expectoration and decreased sputum production and cough severity, but did not significantly change lung function compared to placebo (71). Similarly, in a small pilot study comparing erdosteine plus chest physiotherapy versus physiotherapy alone, the treatment group exhibited improvement in sputum purulence and small but statistically significant improvements in lung function when compared to the control group (72).
The influence of erdosteine administration on lead-induced oxidative stress in rat muscle
Published in Drug and Chemical Toxicology, 2022
Michał Dobrakowski, Anna Machoń-Grecka, Przemysław Nowak, Patrycja Szczęsny, Maciej Maciejczyk, Aleksandra Kasperczyk, Tomasz Pryzwan, Sławomir Kasperczyk
The above-mentioned encouraging results prompted us to investigate erdosteine which is a more recently developed mucolytic drug addressing some of the problems associated with the older drugs (Dal Negro et al. 2017). Erdosteine is a prodrug molecule containing two sulfur atoms, one of which is blocked in the aliphatic side chain and the other enclosed in the heterocyclin ring. In alkaline environment, erdosteine is transformed to its active metabolite containing free thiol group available for pharmacological activity. Erdosteine has been not only shown to be capable of breaking the disulfide bonds of mucin, but also to inhibit inflammatory response via blocking the NF-kB pathway and suppressing synthesis of some cytokines, including tumor necrosis factor alpha (TNF-α) and IL-1β (Dal Negro et al. 2018). Besides, the free radical scavenging activity of erdosteine resulting in reduced lipid peroxidation, neutrophil infiltration, and cell apoptosis, has been confirmed in various types of tissue injuries mediated by products of oxidative stress (Barlas et al. 2017).
Role of the mucins in pathogenesis of COPD: implications for therapy
Published in Expert Review of Respiratory Medicine, 2020
Federica Lo Bello, Antonio Ieni, Philip M. Hansbro, Paolo Ruggeri, Antonino Di Stefano, Francesco Nucera, Irene Coppolino, Francesco Monaco, Giovanni Tuccari, Ian M. Adcock, Gaetano Caramori
Two double-blind randomized controlled trials also assessed erdosteine in combination with antibacterial therapy in patients with COPD exacerbations. The first study was double-blind, parallel group study that evaluated 237 COPD patients treated with erdosteine or placebo in association with amoxicillin for a minimum of 7 days and a maximum of 10 days [133]. Exacerbations were defined by the presence of functional signs of chronic bronchitis in the exacerbation phase according to ATS standard (1987). Concomitant treatments with mucoactives, anti-inflammatories including glucocorticoids, oral beta2-agonists, diuretics, anticholinergics, anti-histamines and calcium blockers were avoided during the trial, but inhaled beta2-agonist were allowed as required except for the last 12 hours before each clinical visit [133].
Contemporary management of bronchiectasis in children
Published in Expert Review of Respiratory Medicine, 2019
Johnny Wu, Anne B Chang, Danielle F Wurzel
The rationale behind use of hyperosmolar agents and mucolytics is to facilitate mucus clearance in conjunction with airway clearance techniques. A 2014 Cochrane review showed the overall evidence for mucolytics in bronchiectasis was lacking and although some agents may be useful, others (e.g. DNAse B) are harmful and more robust longer-term studies are required [41]. Erdosteine, a novel synthesized thiol similar to N-acetylcysteine (but without the toxicity from systemic free thiol generation) has shown promise in trials in adults with COPD/chronic bronchitis [42]. An RCT evaluating erdosteine and azithromycin therapy in children with PCD has been registered [43].