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Review
. 2022 Jun 14;14(6):1261.
doi: 10.3390/pharmaceutics14061261.

Clinical Efficacy of Carbocysteine in COPD: Beyond the Mucolytic Action

Elisabetta Pace  1 , Isa Cerveri  2 , Donato Lacedonia  3 , Gregorino Paone  4 , Alessandro Sanduzzi Zamparelli  5 , Rossella Sorbo  6 , Marcello Allegretti  6 , Luigi Lanata  6 , Francesco Scaglione  7
Affiliations
Review

Clinical Efficacy of Carbocysteine in COPD: Beyond the Mucolytic Action

Elisabetta Pace et al. Pharmaceutics. .

Abstract

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with a versatile and complicated profile, being the fourth most common single cause of death worldwide. Several research groups have been trying to identify possible therapeutic approaches to treat COPD, such as the use of mucoactive drugs, which include carbocysteine. However, their role in the treatment of patients suffering from COPD remains controversial due to COPD's multifaceted profile. In the present review, 72 articles, published in peer-reviewed journals with high impact factors, are analyzed in order to provide significant insight and increase the knowledge about COPD considering the important contribution of carbocysteine in reducing exacerbations via multiple mechanisms. Carbocysteine is in fact able to modulate mucins and ciliary functions, and to counteract viral and bacterial infections as well as oxidative stress, offering cytoprotective effects. Furthermore, carbocysteine improves steroid responsiveness and exerts anti-inflammatory activity. This analysis demonstrates that the use of carbocysteine in COPD patients represents a well-tolerated treatment with a favorable safety profile, and might contribute to a better quality of life for patients suffering from this serious illness.

Keywords: carbocysteine; carbocysteine COPD; carbocysteine human diseases; carbocysteine lung diseases; carbocysteine pharmacology.

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Conflict of interest statement

E.P. reports grants from Dompè for the submitted work and during the previous 36 months. I.C. reports grants from Dompè for the submitted work and during the previous 36 months. D.L. reports grants from Dompè for the submitted work and during the previous 36 months. G.P. reports grants from Dompè for the submitted work and during the previous 36 months. A.S.Z. reports personal fees from Dompè, Astra Zeneca, GSK, Guidotti, Menarini, and Boehringer Ingelheim outside the submitted work. R.S. is an employee of Dompé Farmaceutici SpA. M.A. is an employee of Dompé Farmaceutici SpA. L.L. is an employee of Dompé Farmaceutici SpA. F.S. reports grants from Dompè for the submitted work and from Pfizer, GSK, Bayer, Angelini, Amgen, and Dompè Pharma outside the submitted work.

Figures

Figure 5
Figure 5
Main clinical studies of carbocysteine’s effects in COPD patients [10,26,63,64,65,66,67,68,69,71].
Figure 1
Figure 1
Flow diagram for article selection.
Figure 2
Figure 2
Chemical structure of carbocysteine.
Figure 3
Figure 3
The main molecular mechanisms and effects of carbocysteine in smoke-injured airway epithelial cells.
Figure 4
Figure 4
Overview of the various effects of carbocysteine with a positive impact in COPD.
See this image and copyright information in PMC

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