Comparison of effectiveness of acetylcysteine and 3% hypertonic saline inhalation in patients with COPD

<bold>Background:</bold> Despite good compliance to prescribed baseline therapy some patients with COPD in the stable phase have complaints of productive cough with difficulty in its expectoration. <bold>Aims and objectives:</bold> To determine and compare the efficacy of nebulized therapy of acetylcysteine (NAC) and 3% hypertonic saline (HS) in COPD patients without exacerbation. <bold>Methods:</bold> 60 patients with COPD were included in the study. Two equal groups were formed. In the first group, patients inhaled NAC (600 mg/day), in the second one – 4 mL of 3% sodium chloride solution twice a day. Duration of nebulized therapy in each group was 10 days. The baseline therapy was unchanged. The clinical findings were estimated by questionnaires CAT, CCQ, mMRC, daytime and nighttime cough scale. Spirometry was also performed. <bold>Results:</bold> Both groups showed improvement in symptoms according to the CAT and CCQ questionnaires (decrease by 12.7% and 8.3% accordingly in NAC group and by 8.7% and 8.8% in HS group, p<0.03). The first group also showed decrease in the severity of daytime cough by 14.0% and nighttime cough by 33.9%. Similar results were obtained in second group (decrease of daytime cough by 12.1% and nighttime cough by 44.0%). In the group of patients taking NAC, FEV1 significantly improved (9.3%, p<0.02), elevation of FEV1 in HS group was not achieved. Changes in the severity of dyspnea were not statistically significant in both groups. <bold>Conclusions:</bold> Additional administration of mucoactive drugs such as NAC and 3% HS in patients with COPD without exacerbation has positive effects on the intensity of the symptoms; nebulized NAC also positively influences the level of obstructive changes according to spirometry.