SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2023
Mucolytics for acute exacerbations of chronic obstructive pulmonary disease: a meta-analysis.
Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- InhaledEuropean respiratory review : an official journal of the European Respiratory Society · 2024Pooled it
- Mucolytics for acute exacerbations of chronic obstructive pulmonary disease: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Safety and efficacy of inhalable ambroxol hydrochloride aerosol for adult patients with respiratory diseases: an open-label, single-arm, multicentre study.BMJ open respiratory research · 2025Trial
- Mucoactive Agents in Muco-Obstructive Lung Diseases: A Critical Reappraisal of Pharmacological Effects and Clinical Outcomes.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Application of machine learning models for predicting risk factors of acute exacerbations in chronic obstructive pulmonary disease.Frontiers in medicine · 2026Article
- N-acetylcysteine: evidence based consensus document on the therapeutic advantages in respiratory diseases (NECTAR).Frontiers in medicine · 2026Review
- Association between terbutaline sulfate plus ambroxol hydrochloride and clinical outcomes, pulmonary function, and inflammatory biomarkers in elderly patients with acute exacerbation of chronic obstructive pulmonary disease.Frontiers in pharmacology · 2026Article
- Efficacy and safety of Qingbu Weijing decoction in treatment stable bronchiectasis: study protocol for a multicenter, double- blind, randomized and placebo-controlled trial.BMC complementary medicine and therapies · 2025Article
- Airway Mucus Plugs on Chest Computed Tomography Are Associated with Exacerbations in Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2025Article
- FeFrontiers in physiology · 2025Article
- Mucolytic Therapy in COPD: Patient Usage and Preferences in Real-World Italian Settings.International journal of chronic obstructive pulmonary disease · 2025Article
- Focused Pulse High-frequency Chest Wall Oscillation (FP-HFCWO) for Mucus Management in COPD (Chronic Obstructive Pulmonary Disease) and Asthma: A Single-center Cohort Study.The open respiratory medicine journal · 2025Article
- Article
- Bronchiectasis-COPD Overlap Syndrome: A Comprehensive Review of its Pathophysiology and Potential Cardiovascular Implications.Therapeutic advances in pulmonary and critical care medicineReview
- Observational study on the prescription practices of family and pulmonary physicians for airway clearance devices in chronic obstructive pulmonary disease management.Therapeutic advances in respiratory diseaseObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This meta-analysis explored the safety and effectiveness of mucolytics as an add-on treatment for chronic obstructive pulmonary disease (COPD) exacerbations. Based on a pre-registered protocol and following Cochrane methods, we systematically searched for relevant randomised or quasi-randomised controlled trials (RCTs). We used the Risk of Bias v2 tool for appraising the studies and performed random-effect meta-analyses when appropriate. We assessed certainty of evidence using GRADE. This meta-analysis included 24 RCTs involving 2192 patients with COPD exacerbations, entailing at least some concerns of methodological bias. We demonstrated with moderate certainty that mucolytics increase the rate of treatment success (relative risk 1.37, 95% CI 1.08-1.73, n=383), while they also exert benefits on overall symptom scores (standardised mean difference 0.86, 95% CI 0.63-1.09, n=316), presence of cough at follow-up (relative risk 1.93, 95% CI 1.15-3.23) and ease of expectoration (relative risk 2.94, 95% CI 1.68-5.12). Furthermore, low or very low certainty evidence suggests mucolytics may also reduce future risk of exacerbations and improve health-related quality of life, but do not impact on breathlessness, length of hospital stay, indication for higher level of care or serious adverse events. Overall, mucolytics could be considered for COPD exacerbation management. These findings should be validated in further, rigorous RCTs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.