{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:15:07Z","timestamp":1791810907384,"version":"4.3.4"},"reference-count":32,"publisher":"European Respiratory Society (ERS)","issue":"4","funder":[{"name":"Edmond Pharma"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2017,7,15]]},"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:p>Oxidative stress contributes to chronic obstructive pulmonary disease (COPD) exacerbations and antioxidants can decrease exacerbation rates, although we lack data about the effect of such drugs on exacerbation duration.<\/jats:p><jats:p>The RESTORE (Reducing Exacerbations and Symptoms by Treatment with ORal Erdosteine in COPD) study was a prospective randomised, double-blind, placebo-controlled study, enrolling patients aged 40\u201380\u2005years with Global Initiative for Chronic Obstructive Lung Disease stage II\/III. Patients received erdosteine 300\u2005mg twice daily or placebo added to usual COPD therapy for 12\u2005months. The primary outcome was the number of acute exacerbations during the study.<\/jats:p><jats:p>In the pre-specified intention-to-treat population of 445 patients (74% male; mean age 64.8\u2005years, forced expiratory volume in 1\u2005s 51.8% predicted) erdosteine reduced the exacerbation rate by 19.4% (0.91<jats:italic>versus<\/jats:italic>. 1.13 exacerbations\u00b7patient<jats:sup>\u22121<\/jats:sup>\u00b7year<jats:sup>\u22121<\/jats:sup>for erdosteine and placebo, respectively; p=0.01), due to an effect on mild events; the reduction in the rate of mild exacerbations was 57.1% (0.23<jats:italic>versus<\/jats:italic>0.54 exacerbations\u00b7patient<jats:sup>\u22121<\/jats:sup>\u00b7year<jats:sup>\u22121<\/jats:sup>for erdosteine and placebo, respectively; p=0.002). No significant difference was observed in the rate of moderate and severe exacerbations (0.68<jats:italic>versus<\/jats:italic>0.59 exacerbations\u00b7patient<jats:sup>\u22121<\/jats:sup>\u00b7year<jats:sup>\u22121<\/jats:sup>for erdosteine and placebo, respectively; p=0.054) despite a trend in favour of the comparison group. Erdosteine decreased the exacerbation duration irrespective of event severity by 24.6% (9.55<jats:italic>versus<\/jats:italic>12.63\u2005days for erdosteine and placebo, respectively; p=0.023). Erdosteine significantly improved subject and physician subjective severity scores (p=0.022 and p=0.048, respectively), and reduced the use of reliever medication (p&lt;0.001), but did not affect the St George's Respiratory Questionnaire score or the time to first exacerbation.<\/jats:p><jats:p>In patients with COPD, erdosteine can reduce both the rate and duration of exacerbations. The percentage of patients with adverse events was similar in both the placebo and erdosteine treatment groups.<\/jats:p>","DOI":"10.1183\/13993003.00711-2017","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T17:55:07Z","timestamp":1508781307000},"page":"1700711","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":96,"title":["Effect of erdosteine on the rate and duration of COPD exacerbations: the RESTORE study"],"prefix":"10.1183","volume":"50","author":[{"given":"Roberto W.","family":"Dal Negro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadwiga A.","family":"Wedzicha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Iversen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Fontana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive","family":"Page","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arrigo F.","family":"Cicero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Pozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.A.","family":"Calverley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2017,10,12]]},"reference":[{"key":"2024101904274230000_50.4.1700711.1","doi-asserted-by":"crossref","first-page":"170021","DOI":"10.1183\/13993003.00214-2017","article-title":"Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary","volume":"49","author":"Vogelmeier","year":"2017","journal-title":"Eur Respir J"},{"key":"2024101904274230000_50.4.1700711.2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200310-1443OC"},{"key":"2024101904274230000_50.4.1700711.3","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.157.5.9709032"},{"key":"2024101904274230000_50.4.1700711.4","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.10.847"},{"key":"2024101904274230000_50.4.1700711.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105482"},{"key":"2024101904274230000_50.4.1700711.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1516385"},{"key":"2024101904274230000_50.4.1700711.7","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1164\/rccm.201607-1421OC","article-title":"Effect of fluticasone furoate and vilanterol on exacerbations of COPD in patients with moderate airflow obstruction","volume":"195","author":"Martinez","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2024101904274230000_50.4.1700711.8","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-200768"},{"key":"2024101904274230000_50.4.1700711.9","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00092506"},{"key":"2024101904274230000_50.4.1700711.10","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201412-2269OC"},{"key":"2024101904274230000_50.4.1700711.11","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(13)70286-8"},{"key":"2024101904274230000_50.4.1700711.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60869-7"},{"key":"2024101904274230000_50.4.1700711.13","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00003510"},{"key":"2024101904274230000_50.4.1700711.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.pupt.2007.07.004"},{"key":"2024101904274230000_50.4.1700711.15","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.pupt.2015.06.004","article-title":"Efficacy of erdosteine 900 versus 600","volume":"33","author":"Dal Negro","year":"2015","journal-title":"Pulm Pharmacol Ther"},{"key":"2024101904274230000_50.4.1700711.16","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1159\/000063223","article-title":"Bacterial adhesiveness: effects of the SH metabolite of erdosteine (mucoactive drug) plus clarithromycin versus clarithromycin alone","volume":"47","author":"Braga","year":"2001","journal-title":"Chemotherapy"},{"key":"2024101904274230000_50.4.1700711.17","first-page":"143","article-title":"The effect of long-term treatment with erdosteine on chronic obstructive pulmonary disease: the EQUALIFE Study","volume":"30","author":"Moretti","year":"2004","journal-title":"Drugs Exp Clin Res"},{"key":"2024101904274230000_50.4.1700711.18","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00161507"},{"key":"2024101904274230000_50.4.1700711.19","doi-asserted-by":"publisher","DOI":"10.1378\/chest.117.2.398"},{"key":"2024101904274230000_50.4.1700711.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66456-2"},{"key":"2024101904274230000_50.4.1700711.21","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/S0140-6736(16)31354-X","article-title":"Single inhaler triple therapy versus inhaled corticosteroid plus long-acting \u03b22-agonist therapy for chronic obstructive pulmonary disease (TRILOGY): a double-blind, parallel group, randomised controlled trial","volume":"388","author":"Singh","year":"2016","journal-title":"Lancet"},{"key":"2024101904274230000_50.4.1700711.22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7245.1297"},{"key":"2024101904274230000_50.4.1700711.23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063070"},{"key":"2024101904274230000_50.4.1700711.24","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00179714"},{"key":"2024101904274230000_50.4.1700711.25","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1164\/rccm.201509-1795OC","article-title":"Undiagnosed chronic obstructive pulmonary disease contributes to the burden of health care use. Data from the CanCOLD study","volume":"194","author":"Labont\u00e8","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2024101904274230000_50.4.1700711.26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505971"},{"key":"2024101904274230000_50.4.1700711.27","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-1692"},{"key":"2024101904274230000_50.4.1700711.28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12459-2"},{"key":"2024101904274230000_50.4.1700711.29","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s12890-015-0077-0","article-title":"Reliever salbutamol use as a measure of exacerbation risk in chronic obstructive pulmonary disease","volume":"15","author":"Jenkins","year":"2015","journal-title":"BMC Pulm Med"},{"key":"2024101904274230000_50.4.1700711.30","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201309-305OC"},{"key":"2024101904274230000_50.4.1700711.31","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/resp.12690","article-title":"A rational approach to single, dual and triple therapy in COPD","volume":"21","author":"Calverley","year":"2016","journal-title":"Respirology"},{"key":"2024101904274230000_50.4.1700711.32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-699X.2010.00198.x"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.00711-2017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:44:42Z","timestamp":1740379482000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.00711-2017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2017,10,12]]},"published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1183\/13993003.00711-2017"],"URL":"https:\/\/doi.org\/10.1183\/13993003.00711-2017","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10]]}}}