Therapy with Erespal in patients with chronic obstructive pulmonary disease

Comparative efficacy of long-tem treatment with Erespal (fenspirid, Servier) and Atrovent as the basic therapy of patients with COPD exacerbation was studied. The patients with clinical and laboratory signs of COPD exacerbation were involved in the study. Patients treated by oral or inhaled glucocorticosteroids, with severe concomitant diseases and with acute exacerbations of chronic co-existing diseases were excluded. The patients were randomized into 2 groups: the 1-st group patients (n = 35) were treated with Erespal 160 mg daily during 3 months, the 2-nd group patients (n = 32) were treated with Atrovent 40 meg 3 to 4 times daily. The efficacy was evaluated by visual scoring of cough and dyspnoea severity, sputum volume, elastase-like and tripsin-like serum and sputum activities, TNF-a serum and sputum levels, lung function parameters, cell number in induced sputum and bronchial mucus brushing. A reliable improvement (p < 0.05) in clinical symptoms was observed in both the groups at the end of the treatment, but the dyspnoea decreased reliably (p < 0.05) only in the patients treated with Erespal. The lung function parameters were considerably improved (p < 0.05) in both the groups. The elastase-like and tripsin-like serum and sputum activities and the TNF-a serum and sputum levels were significantly decreased (p < 0.05) only in the patients treated with Erespal. The neutrophil number was reliably decreased (p < 0 .0001 ) and macrophages number was reliably increased (p<0 .0 0 0 1 ) in the induced sputum, atrophic and proliferating bronchial epithelial cell counts were reliably decreased (p < 0.05) in the 1-st group patients compared with the 2-nd group. Thus, Erespal is effective antiinflammatory drug for treatment of COPD patients. Persisting bronchial inflammation at clinically stable period (after 3-month therapy) is a reason to include Erespal in the basic therapy of COPD.

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