This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

DE Niewoehner

H Worth

JP Zheng

LJ Wei

M Decramer

NR Anthonisen

P Kaspar

PMA Calverley

PS Burge

PW Jones

R Rodriguez-Rosin

SH Randell

TAR Seemungal

UR Juergens

W Kehrl

W Szafranski

English

PubMed

Heinrich Worth

Christian Schacher

Uwe Dethlefsen

Springer - Publisher Connector

Concomitant therapy with Cineole (Eucalyptole) reduces exacerbations in COPD: A placebo-controlled double-blind trial

Crossref

Abstract Background The clinical effects of mucolytics in patients with chronic obstructive pulmonary disease (COPD) are discussed controversially. Cineole is the main constituent of eucalyptus oil and mainly used in inflammatory airway diseases as a mucolytic agent. We hypothesised that its known mucolytic, bronchodilating and anti-inflammatory effects as concomitant therapy would reduce the exacerbation rate and show benefits on pulmonary function tests as well as quality of life in patients with COPD. Methods In this double-blind, placebo-controlled multi-center-study we randomly assigned 242 patients with stable COPD to receive 200 mg of cineole or placebo 3 times daily as concomitant therapy for 6 months during winter-time. The frequency, duration and severity of exacerbations were combined as primary outcome measures for testing as multiple criteria. Secondary outcome measures included changes of lung function, respiratory symptoms and quality of life as well as the single parameters of the exacerbations. Results Baseline demographics, lung function and standard medication of both groups were comparable. During the treatment period of 6 months the multiple criteria frequency, severity and duration of exacerbations were significantly lower in the group treated with cineole in comparison to placebo. Secondary outcome measures validated these findings. Improvement of lung function, dyspnea and quality of life as multiple criteria were statistically significant relative to placebo. Adverse events were comparable in both groups. Conclusion Concomitant therapy with cineole reduces exacerbations as well as dyspnea and improves lung function and health status. This study further suggests cineole as an active controller of airway inflammation in COPD by intervening in the pathophysiology of airway inflammation of the mucus membrane. Trial registration ISRCTN07600011</p

Schacher Christian

Worth Heinrich

Dethlefsen Uwe

Directory of Open Access Journals

Respiratory Research

Airway epithelial stem cells and the pathophysiology of chronic obstructive pulmonary disease. Proc Am Thorac Soc

Anti-inflammatory Effects of Eucalyptol (1.8-Cineole) in Bronchial Asthma: Inhibition of Arachidonic Acid Metabolism in Human Blood Monocytes Ex Vivo.

Ardia A: Effects of N-acetylcysteine on outcomes in chronic obstructive disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCHUS): a randomized placebo-controlled trial. Lancet

Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomized controlled trial. Lancet

Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J

for the TORCH investigators: Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease.

Global Strategy for Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease Update

H: Anti-inflammatory activity of 1.8-Cineole (Eucalyptole) in bronchial asthma: a double-blind placebo controlled trial. Respiratory Medicine

H: Inhibitory activity of 1,8-cineol (eucalyptol) on cytokine production in human mononuclear phagocytes in vitro. Pulm Pharmacol Ther

H: Maintenance therapy with budenoside and formoterol in chronic obstructive pulmonary disease. Eur Respir J

Lachin JM: Two-sample asymptotically distributionfree tests for incomplete multivariate observations.

Littlejohns P: A Self-complete Measure of Health Status for Chronic Airflow Limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis

NA: Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med

Prevention of exacerbations of chronic obstructive pulmonary disease with tiotropium, a once-daily inhaled anticholinergic bronchodilator. Ann Intern Med

Prevention of Exacerbations: How are we doing and can we do better? Proc Am Thoracic Soc

Sekretolytika im Vergleich, Änderung der Ziliarfrequenz und Lungenfunktion nach Therapie mit Cineol und Ambroxol. Atemw-Lungenkrkh

Therapy of acute nonpurulent rhinosinusitis with cineole: results of a double-blind, randomized, placebo-controlled trial. Laryngoscope

TK: Randomised, double-blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial. BMJ

Toward a consensus definition for COPD exacerbations. Chest

U: Effects of Cineol and Ambroxol on Different Parameters of Lung Function

Wedzicha JA: Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J respir Crit Care Med

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

http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.152.539

Concomitant therapy with Cineole (Eucalyptole) reduces exacerbations in COPD: A placebo-controlled double-blind trial

Abstract

Similar works

Full text

Available Versions

Springer - Publisher Connector

Crossref

Directory of Open Access Journals