Oral and inhalation usage of acetylcysteine in patients with COPD

<b>Background:</b> Some patients with COPD in a stable phase and with a baseline therapy continue to complain of shortness of breath and cough with sputum production difficulty. These patients additionally take mucolytics such as acetylcysteine. <b>Aims and Objectives:</b> To determine the efficacy and safety of the nebulized therapy of acetylcysteine compared to its oral administration in patients with COPD. <b>Methods:</b> The study included 31 patients with COPD without exacerbation. They were divided into 2 groups. The first group (n=13) took 600 mg/day acetylcysteine orally, and the second one (n=18) inhaled 600 mg/day acetylcysteine from a nebulizer for 10 days receiving the unchanged baseline therapy. Data from questionnaires (CAT, mMRC, CCQ) were evaluated, day and night cough symptoms were assessed on a scale, as well as spirometry and sputum analysis were done. <b>Results:</b> The first group showed an improvement in their condition based on CCQ score (decrease by 15.1%, p&lt;0.04). In other investigations significant dynamics was not registered. There were significant positive changes in CAT results (decrease by 16.8% compared to initial data), reduction in the night cough symptoms (by 36.4%) in the group of patients inhaling acetylcysteine. CCQ, mMRC and daytime cough symptoms values did not change significantly. The increase in FEV1 at 10% (p=0.01) and the decrease in the number of leukocytes in sputum were also registered in second group. Side effects developed infrequently. <b>Conclusions:</b> In patients with COPD who have symptoms in a stable phase, the inhalation of acetylcysteine has a greater effect on the disease manifestation comparing with the oral administration in the same daily dose; the tolerability of treatment is satisfactory.