Table 4 Effect of other therapies on the risk of COPD exacerbation
From: Pharmacological strategies to reduce exacerbation risk in COPD: a narrative review
Treatment [Reference] | Annual exacerbation rate | Comparator | Annual exacerbation rate | Reduction in exacerbations | Exacerbation endpoint | Patient population | |
|---|---|---|---|---|---|---|---|
Exacerbation entry criteria (No./year) | FEV1 % predicted | ||||||
Macrolide antibiotics | |||||||
 Azithromycin [107] | 1.94 | Placebo | 3.22 | 42 % | Primary (any) | ≥3 | NA |
 Azithromycin [108] | 1.48 | Placebo | 1.83 | 27 % | Primary (moderate or severe) | ≥1 severe | <70 % (post-BD) |
 Azithromycin [142] | 2.8 | Baseline | 6.8 | 59 % | Moderate or severe | ≥4 | <50 % (post-BD) |
 Erythromycin [143] | 1 | Placebo | 2 | 35 % | Primary (moderate or severe) | NA | 30–70 % |
Mucolytics | |||||||
 Carbocysteine [144] | 1.01 | Placebo | 1.35 | 25 % | Primary (any) | ≥2 in 2 years | 25–79 % |
 N-acetylcysteine (high dose) [113] | 1.16 | Placebo | 1.49 | 22 % | Primary (any) | NA | 30–70 % |
 N-acetylcysteine [114] | 0.96 | Placebo | 1.71 | 43.9 % | Secondary | ≥1 | Not stated |
 N-acetylcysteine [131] | 1.00 | Placebo | 0.73 | NS | Primary | NA | <90 % (post-BD) |
1.25 | Placebo | 1.29 | NS | Primary | ≥2 (previous 2 years) | 40–70 % (post-BD) | |
PDE-4 inhibitor | |||||||
 Roflumilast [99] | 0.81 | Placebo | 0.93 | NS | Primary (moderate or severe) | ≥2 (and chronic cough/sputum) | <50 % (post-BD) |
 Roflumilast [147] | 1.14 | Placebo | 1.37 | 16.9 % | Primary (moderate or severe) | ≥1 | ≤50 % (post-BD) |
 Roflumilast [97] | 1.14 | Placebo | 1.37 | 17 % (2 studies pooled) | Primary (moderate or severe) | ≥1 (and chronic cough/sputum) | <50 % (post-BD) |
 Roflumilast [148] | 0.86 | Placebo | 0.92 | NS | Primary (moderate or severe) | NA | <50 % (post-BD) |