Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum94075ArticlesСтатьиResearch ArticleRandomizirovannoe dvoynoe slepoe platsebo-kontroliruemoe issledovanie PANTHEON: primenenie N-atsetiltsisteina v doze 600 mg 2 raza v den' dlya preduprezhdeniya obostreniy khronicheskoy obstruktivnoy bolezni legkikhРандомизированное двойное слепое плацебо-контролируемое исследование PANTHEON: применение N-ацетилцистеина в дозе 600 мг 2 раза в день для предупреждения обострений хронической обструктивной болезни легкихZhengJin-PingWenFu-QiangBaiChun-XueWanHuan-YingKangJianChenPingYaoWan-ZhenMaLi-junLiXiaRaiteriLucaSardinaMarcoGaoYiWangBai-SongZhongNan-ShanState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respi- ratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaWest China Hospital, Sichuan University, Chengdu, ChinaZhongshan Hospital, Fudan University, Shanghai, ChinaRui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaFirst Affiliated Hospital of China Medical University, Shenyang, ChinaShenyang PLA General Hospital, Shenyang, ChinaPeking University Third Hospital, Beijing, ChinaHenan Provincial People's Hospital, Zhengzhou, ChinaHainan Zambon Pharmaceutical, Beijing, ChinaInnovation & Medical Sciences Department, Zambon, Bresso, Milan, ItalyMedKey Med-Tec Development, Shanghai, China15032014163VOL 16, NO3 (2014)ТОМ 16, №3 (2014)748128122021Copyright ©; 2014, Consilium MedicumCopyright ©; 2014, ООО "Консилиум Медикум"2014Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/94075

Опубликовано: журнал «The Lancet Respiratory Medicine», март 2014; 2 (3): 187-194. Финансирование: Hainan Zambon Pharmaceutical. Целью исследования стали оценка способности долгосрочной высокодозной терапия N-ацетилцистеином снижать число обострений ХОБЛ и изучение зависимости данного эффекта от использования сопутствующей терапии ИГКС.В исследовании PANTHEON принимали участие только китайские пациенты. Можно прогнозировать, что хороший клинический эффект возможно получить и у пациентов с ХОБЛ I стадии, и данное положение должно стать предметом будущих исследований. Необходимо также проведение фармакоэкономического анализа предлагаемой терапии.

хроническая обструктивная болезнь легкихтерапияантиоксидантыN-ацетилцистеинVestbo J, Hurd S.S, Agustf A.G et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013; 187: 347-65.Donaldson G.C, Seemungal T.A, Bhowmik A, Wedzicha J.A. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002; 57: 847-52.Spencer S, Calverley P.M, Burge P.S, Jones P.W. Impact of preventing exacerbations on deterioration of health status in COPD. Eur Respir J 2004; 23: 698-702.Wouters E.F. The burden of COPD in The Netherlands: results from the confronting COPD survey. Respir Med 2003; 97 (Suppl. C): S51-59.Blackwell T.S, Blackwell T.R, Holden E.P et al. In vivo antioxidant treatment suppresses nuclear factor - kappa B activation and neutrophilic lung inflammation. J Immunol 1996; 157: 1630-377.van Overveld F.J, Demkow U, Gorecka D et al. New developments in the treatment of COPD: comparing the effects of inhaled corticosteroids and N-acetylcysteine. J Physiol Pharmacol 2005; 56 (Suppl. 4): 135-42.Dekhuijzen P.N.R. Antioxidant properties of N-acetylcysteine: their relevance in relation to chronic obstructive pulmonary disease. Eur Respir J 2004; 23: 629-36.Ueno T, Yamada M, Igarashi Y, Ogawa T. N-acetylcysteine protects osteoblastic function from oxidative stress. J Biomed Mater Res A 2011; 99: 523-31.Sadowska A.M, Manuel-Y-Keenoy B, De Backer W.A. Antioxidant and antiinflammatory efficacy of NAC in the treatment of COPD: discordant in vitro and in vivo dose - effects: a review. Pulm Pharmacol Ther 2007; 20: 9-22.Grandjean E.M, Berthet P, Ruffmann R, Leuenberger P. Efficacy of oral long - term N-acetylcysteine in chronic bronchopulmonary disease: a meta - analysis of published double - blind, placebo - controlled clinical trials. Clin Ther 2000; 22: 209-21.Gerrits C.M, Herings R.M, Leufkens H.G, Lammers J.W. N-acetylcysteine reduces the risk of re - hospitalisation among patients with chronic obstructive pulmonary disease. Eur Respir J 2003; 21: 795-98.Decramer M, Rutten - van Mölken M, Dekhuijzen P.N et al. Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomised on N-acetylcysteine Cost-Utility Study, BRONCUS): a randomised placebo - controlled trial. Lancet 2005; 365: 1552-60.Schermer T, Chavannes N, Dekhuijzen R et al. Fluticasone and N-acetylcysteine in primary care patients with COPD or chronic bronchitis. Respir Med 2009; 103: 542-51.Zuin R, Palamidese A, Negrin R et al. High dose N-acetylcysteine in patients with exacerbations of chronic obstructive pulmonary disease. Clin DrugInvestig 2005; 25: 401-8.Zheng J.P, Wen F.Q, Bai C.X et al. High - dose N-acetylcysteine in the prevention of COPD exacerbations: rationale and design of the PANTHEON study. COPD 2013; 10: 164-71.Anthonisen N.R, Manfreda J, Warren C.P.W et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106: 196-204.Burge S, Wedzicha J.A. COPD exacerbations: definitions and classifications. Eur Respir J 2003; 21 (Suppl. 41): 46-53.Zheng J.P, Kang J, Huang S.G et al. Effect of carbocisteine on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo - controlled study. Lancet 2008; 371: 2013-18.Calverley P.M, Anderson J.A, Celli B et al. TORCH investigators. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med 2007; 356: 775-89.Tashkin D.P, Celli B, Senn S et al, for the UPLIFT study investigators. A 4-year trial of tiotropium in chronic obstructive pulmonary disease. N Engl J Med 2008; 359: 1543-54.Zhou Y, Wang X, Zeng X et al. Positive benefits of theophylline in a randomised, double - blind, parallel - group, placebo controlled study of low - dose, slow - release theophylline in the treatment of COPD for 1 year. Respirology 2006; 11: 603-10.Tse H.N, Raiteri L, Wong K.Y et al. High - dose N-acetylcysteine in stable chronic obstructive pulmonary disease: the 1-year, double - blind, randomised, placebo - controlled HIACE study. Chest 2013; 144: 106-18.Jenkins C.R, Jones P.W, Calverley P.M et al. Efficacy of salmeterol/fluticasone propionate by GOLD stage of chronic obstructive pulmonary disease: analysis from the randomised, placebo - controlled TORCH study. Respir Res 2009; 10: 59.Decramer M, Celli B, Kesten S et al, for the UPLIFT investigators. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLIFT): a prespecified subgroup analysis of a randomised controlled trial. Lancet 2009; 374: 1171-78.Zheng J.P, Zhong N.S, Jiang M, Zeng G.Q. Carbocisteine for acute exacerbations of COPD - authors' reply. Lancet 2008; 372: 1631-32.Hurst J.R, Vestbo J, Anzueto A et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 2010; 363: 1128-38.Zheng J.P, Yang L, Wu Y.M et al. The efficacy and safety of combination salmeterol (50 µg)/fluticasone propionate (500 µg) inhalation twice daily via Accuhaler in Chinese patients with COPD. Chest 2007; 132:1756-63.Zhong N, Wang C, Yao W et al. Prevalence of chronic obstructive pulmonary disease in China: a large population - based survey. Am J Respir Crit Care Med 2007; 176: 753-60.Calverley P, Pauwels R, Vestbo J et al. Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 2003; 361: 449-56.Thomsen M, Nordestgaard B.G, Vestbo J et al. Characteristics and outcomes of chronic obstructive pulmonary disease in never smokers in Denmark: a prospective population study. Lancet Respir Med 2013; 1: 543-50.Zhong N, Zheng J, Wen F et al. Efficacy and safety of budesonide/ formoterol via a dry powder inhaler in Chinese patients with chronic obstructive pulmonary disease. Curr Med Res Opin 2012; 28: 257-65.Stav D, Raz M. Effect of N-acetylcysteine on air trapping in COPD: a randomised placebo - controlled study. Chest 2009; 136: 381-86.Mata M, Sarrion I, Armengot M et al. Respiratory syncytial virus inhibits ciliagenesis in differentiated normal human bronchial epithelial cells: effectiveness of N-acetylcysteine. PLoS One 2012; 7: e48037.