PURPOSE:Respiratory tract infection is the commonest cause of exacerbation of COPD. It is necessary to explore new alternatives for the prevention of infection responsible for acute exacerbations. Our aim was to study the role of oral immunostimulating therapy (OIST) in acute infective exacerbations of COPD. OIST is the product of alkaline proteolysis from lysates of six common bacteria implicated in infective exacerbations of COPD.
METHODS:The study was a placebo-controlled randomised clinical trial to study the effect of an immunostimulating agent to prevent acute respiratory exacerbations in patients with COPD. 200 patients (100 placebo and 100 immunostimulant) were followed at outpatient department for six months. The parameters chosen to assess efficacy are: 1) Number of attacks of respiratory tract infection, its duration, severity and average number of re-infection during the six months study, 2) treatment outcome was assessed by % decrease in antibiotic usage, %decrease in bronchodilator usage, % decrease in cough, % decrease in dyspnoea (% increase in FEV1). The results are expressed as mead(SD) and 95% confidence interval, analysis was done by t-test, p values of <0.001 were considered as statistically significant.
RESULTS:There was significant reduction in the number of acute bronchitis exacerbations (p<0.001), their duration (p<0.001), decrease in the administration of antibiotics(50% vs 5%), bronchodilator usage(40% vs 5%), cough reduction (35% vs 3%), improvement in dyspnoea(% increase in FEV1):(10% VS 3%).
CONCLUSION:Oral immunotherapy is an effective alternative for the prevention of infection responsible for acute exacerbations.
CLINICAL IMPLICATIONS:Immunostimulating agents may be beneficial for patients with COPD by reducing the likelihood of severe respiratory events.
DISCLOSURE:Quibtiya Syed, None.