Oleh Admin Kalbe Medical pada November 20, 2017 07:30

Pengobatan dengan Erdosteine Bermanfaat Mengurangi Frekuensi Gejala dan Durasi Eksaserbasi Penyakit Paru Kronik

PPOK (penyakit paru obstruktif kronik) adalah penyakit peradangan kronik pada saluran napas bawah yang ditandai oleh sesak napas dan batuk dengan produksi dahak yang banyak. Menurut WHO, PPOK adalah penyebab kematian nomor 3 di dunia setelah penyakit jantung koroner dan stroke. Salah satu penyebab kematian pada PPOK adalah adanya eksaserbasi (serangan) PPOK yang ditandai dengan perburukan gejala sesak napas dan batuk berdahak. Menurut badan dunia GOLD (Global Initiative for Chronic Obstructive Lung Disease), ada beberapa pengobatan yang direkomendasikan, antara lain inhalasi kortikosteroid, inhalasi bronkodilator dan mukolitik.

Erdosteine adalah sebuah obat mukolitik golongan thiol yang bekerja secara langsung pada dahak dengan cara memutus ikatan disulfida yang berakibat pada berkurangnya kekentalan dahak. Selain itu, erdosteine juga punya mekanisme tambahan berupa antiinflamasi, antioksidan, dan antiadhesi bakteri. Diduga, apabila pasien PPOK yang mengalami eksaserbasi mendapatkan pengobatan erdosteine, maka akan membantu menurunkan inflamasi pada saluran napas sekaligus membantu mencegah terjadinya eksaserbasi selanjutnya.

Dr. Dal Negro dan tim dari Italia melakukan sebuah penelitian yang dinamakan RESTORE (Reducing Exacerbations and Symptoms by Treatment with ORal Erdosteine in COPD) untuk mengetahui apakah penggunaan erdosteine dapat bermanfaat untuk mengurangi frekuensi dan durasi eksaserbasi PPOK. Penelitian ini dilakukan dengan desain acak, tersamar ganda, kontrol plasebo. Pasien yang diikutsertakan berusia 40 – 80 tahun dengan PPOK stadium 2 atau 3 dengan jumlah total 445 pasien. Subjek mendapatkan pengobatan standar PPOK, kemudian ditambahkan pengobatan erdosteine 2 x 300 mg atau plasebo, selama 12 bulan.

Hasil dari penelitian ini adalah pasien yang mendapatkan erdosteine mengalami penurunan jumlah eksaserbasi sebesar 19,4% dibandingkan dengan plasebo. Erdosteine memperpendek durasi eksaserbasi secara bermakna sebesar 24,6%. Erdosteine secara bermakna memperbaiki gejala dan mengurangi kebutuhan pasien akan obat-obatan. Kejadian tidak diinginkan tidak berbeda bermakna antara kedua kelompok.

Kesimpulan:
Pada pasien penyakit paru obstruktif kronik, penggunaan erdosteine 2 x 300 mg dalam jangka panjang (12 bulan) secara bermakna mengurangi frekuensi dan durasi eksaserbasi PPOK. (NNO)

Image : Ilustrasi
Referensi:
1.Global Initiative for Chronic Obstructive Lung Disease. GOLD reports [Internet]. [cited 2017 Oct 28]. Available from: http://goldcopd.org/
2.Erdosteine for COPD exacerbations. Drug Ther Bull. 2008;46(10):79–80.
3.Dal Negro RW, Wedzicha JA, Iversen M, Fontana G, Page C, Cicero AF, et al. Effect of erdosteine on the rate and duration of COPD exacerbations: the RESTORE study. Eur Respir J. 2017 Oct;50(4).

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