Effects of YuPingFeng granules on acute exacerbations of COPD: a randomized, placebo-controlled study.

Ma, Jinfang; Zheng, Jinping; Zhong, Nanshan; Bai, Chunxue; Wang, Haoyan; Du, Juan; Li, Fenglei; Chen, Yanwei; Shi, Zhe; Li, Xin; Chen, Pingyan

doi:10.2147/COPD.S170555

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Effects of YuPingFeng granules on acute exacerbations of COPD: a randomized, placebo-controlled study.

Author(s): Jinfang Ma ¹ , Jinping Zheng ¹ , Nanshan Zhong ¹ , Chunxue Bai ² , Haoyan Wang ³ , Juan Du ⁴ , Fenglei Li ⁵ , Yanwei Chen ⁶ , Zhe Shi ⁷ , Xin Li ⁸ , Pingyan Chen ⁹

Publication date (Electronic): October 17 2018

Journal: International journal of chronic obstructive pulmonary disease

Publisher: Informa UK Limited

Keywords: COPD, YuPingFeng, exacerbation, treatment

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Abstract

Recurrence of acute exacerbations has a major impact on patients with COPD. Therefore, effective prevention and treatment of exacerbation is crucial in the management of COPD, especially for patients with moderate to severe disease. This study evaluated the effectiveness of YuPingFeng granule administration in preventing exacerbation and improving symptom score, as well as its long-term (1 year) safety profile, in patients with COPD.

Most cited references 21

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Susceptibility to exacerbation in chronic obstructive pulmonary disease.

John R. Hurst, Jørgen Vestbo, Antonio Anzueto … (2010)

Although we know that exacerbations are key events in chronic obstructive pulmonary disease (COPD), our understanding of their frequency, determinants, and effects is incomplete. In a large observational cohort, we tested the hypothesis that there is a frequent-exacerbation phenotype of COPD that is independent of disease severity. We analyzed the frequency and associations of exacerbation in 2138 patients enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study. Exacerbations were defined as events that led a care provider to prescribe antibiotics or corticosteroids (or both) or that led to hospitalization (severe exacerbations). Exacerbation frequency was observed over a period of 3 years. Exacerbations became more frequent (and more severe) as the severity of COPD increased; exacerbation rates in the first year of follow-up were 0.85 per person for patients with stage 2 COPD (with stage defined in accordance with Global Initiative for Chronic Obstructive Lung Disease [GOLD] stages), 1.34 for patients with stage 3, and 2.00 for patients with stage 4. Overall, 22% of patients with stage 2 disease, 33% with stage 3, and 47% with stage 4 had frequent exacerbations (two or more in the first year of follow-up). The single best predictor of exacerbations, across all GOLD stages, was a history of exacerbations. The frequent-exacerbation phenotype appeared to be relatively stable over a period of 3 years and could be predicted on the basis of the patient's recall of previous treated events. In addition to its association with more severe disease and prior exacerbations, the phenotype was independently associated with a history of gastroesophageal reflux or heartburn, poorer quality of life, and elevated white-cell count. Although exacerbations become more frequent and more severe as COPD progresses, the rate at which they occur appears to reflect an independent susceptibility phenotype. This has implications for the targeting of exacerbation-prevention strategies across the spectrum of disease severity. (Funded by GlaxoSmithKline; ClinicalTrials.gov number, NCT00292552.)

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Tiotropium in Early-Stage Chronic Obstructive Pulmonary Disease

Yumin Zhou, Nan-shan Zhong, Xiaochen Li … (2017)

Patients with mild or moderate chronic obstructive pulmonary disease (COPD) rarely receive medications, because they have few symptoms. We hypothesized that long-term use of tiotropium would improve lung function and ameliorate the decline in lung function in patients with mild or moderate COPD.

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Effect of carbocisteine on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo-controlled study.

Qiang Li, Lan Yang, Zhen Wang … (2008)

Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation, and has many components including mucus hypersecretion, oxidative stress, and airway inflammation. We aimed to assess whether carbocisteine, a mucolytic agent with anti-inflammatory and antioxidation activities, could reduce the yearly exacerbation rate in patients with COPD. We did a randomised, double-blind, placebo-controlled study of 709 patients from 22 centres in China. Participants were eligible if they were diagnosed as having COPD with a postbronchodilator forced expiratory volume in 1 s (FEV(1)) to forced vital capacity (FVC) ratio (FEV(1)/FVC) of less than 0.7 and an FEV(1) between 25% and 79% of the predicted value, were aged between 40 and 80 years, had a history of at least two COPD exacerbations within the previous 2 years, and had remained clinically stable for over 4 weeks before the study. Patients were randomly assigned to receive 1500 mg carbocisteine or placebo per day for a year. The primary endpoint was exacerbation rate over 1 year, and analysis was by intention to treat. This trial is registered with the Japan Clinical Trials Registry (http://umin.ac.jp/ctr/index/htm) number UMIN-CRT C000000233. 354 patients were assigned to the carbocisteine group and 355 to the placebo group. Numbers of exacerbations per patient per year declined significantly in the carbocisteine group compared with the placebo group (1.01 [SE 0.06] vs 1.35 [SE 0.06]), risk ratio 0.75 (95% CI 0.62-0.92, p=0.004). Non-significant interactions were found between the preventive effects and COPD severity, smoking, as well as concomitant use of inhaled corticosteroids. Carbocisteine was well tolerated. Mucolytics, such as carbocisteine, should be recognised as a worthwhile treatment for prevention of exacerbations in Chinese patients with COPD.

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Author and article information

Journal

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Title: International journal of chronic obstructive pulmonary disease

Publisher: Informa UK Limited

ISSN (Electronic): 1178-2005

ISSN (Print): 1176-9106

Publication date (Electronic): October 17 2018

Volume: 13

Affiliations

[1 ] State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China, 18928868238@163.com, nanshan@vip.163.com.

[2 ] Department of Respiratory Medicine, Zhongshan Hospital Affiliated to Fudan University, Shanghai, People's Republic of China.

[3 ] Department of Respiratory Medicine, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, People's Republic of China.

[4 ] Department of Respiratory Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China.

[5 ] Department of Respiratory Medicine, The Liwan Hospital of the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China.

[6 ] Department of Respiratory Medicine, Nanshan People's Hospital, Shenzhen, People's Republic of China.

[7 ] Department of Respiratory Medicine, The First People's Hospital, Huizhou, People's Republic of China.

[8 ] Department of Respiratory Medicine, China Resource and Wisco General Hospital, Wuhan, People's Republic of China.

[9 ] Department of Biostatistics, Southern Medical University, Guangzhou, People's Republic of China.