Carbocysteine in the Management of Stable COPD: Are Its Antioxidant and Anti-Inflammatory Properties Clinically Relevant?

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Jordan Minov
Jovanka Karadzinska-Bislimovska
Tatjana Petrova
Kristin Vasilevska
Saso Stoleski
Dragan Mijakoski
Aneta Atanasovska


BACKGROUND: The recent epidemiological and experimental evidence suggest possible antioxidant effect of carbocysteine in patients with chronic obstructive pulmonary disease (COPD).

AIM: To assess efficacy and tolerability of carbocysteine in the management of stable COPD.

METHODS: We performed an observational, non-randomized, open study (a real life study) including 87 patients with stable COPD (group B and D by combined COPD assessment) divided in two groups, examined group (EG) and control group (CG). All participants were treated with the regular treatment of the stable disease, but in the participants of the EG carbocysteine 1,500 mg daily was added to their regular treatment during the period of two months. The study protocol included completion of the COPD Assessment Test (CAT) and spirometric measurements at initial visit and at the end of the mentioned period.

RESULTS: We found significantly lower mean value of the overall CAT score in the EG at the end of the study as compared to its mean value registered at initial visit (26.9 vs. 24.3; P = 0.007). In regard to certain CAT items, we found significantly lower values of the mean scores related to cough phlegm and sleep disturbances as compared to their mean scores at initial visit. In addition, the mean values of the overall CAT scores at initial visit and at the end of the study in controls were similar. In EG we found significantly higher mean value of the MEF 25-75 at the end of the study as compared to its mean value registered at initial visit (59.3% vs. 67.2%; P = 0.003). There was no significant difference in the mean values of other spirometric parameters at the end of the study as compared to their mean values at initial visit. In controls we registered similar values of all measured spirometric parameters at the end of the study as compared to their values registered at initial visit. Mild gastrointestinal manifestations were registered in 13.3% of the participants of the EG during the examined period.

CONCLUSION: Our findings indicate positive effects of carbocysteine regarding the symptoms and lung function, as well as its good tolerability in the patients with stable COPD.


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How to Cite
Minov J, Karadzinska-Bislimovska J, Petrova T, Vasilevska K, Stoleski S, Mijakoski D, Atanasovska A. Carbocysteine in the Management of Stable COPD: Are Its Antioxidant and Anti-Inflammatory Properties Clinically Relevant?. SEE J Immunol [Internet]. 2017 Dec. 27 [cited 2024 Jun. 16];3(1):1-7. Available from:
Clinical Immunology
Author Biography

Jordan Minov, Institute for Occupational Health of Republic of Macedonia, Skopje – WHO Collaborating Center, Skopje

Personal data

Date of birth: 9 July 1960

Home address: Vladimir Komarov 16-1/7, 1000 Skopje, R. Macedonia

Office address: Institute of Occupational Health of R. Macedonia - WHOCollaborativeCenter and GA2LEN Collaborative Center, II Makedonska brigada 43, 1000 Skopje, R. Macedonia

Tel: + 389 2 2461 387

Fax: + 389 2 2621 428



Education and key qualifications

"¢ Specialist in internal medicine

"¢ Specialist in occupational medicine

"¢ Subspecialist in pulmonology and allergology


Present appointment

"¢ Head of the Department for Physiology of Work at the Institute for Occupational Health of R. Macedonia – WHO Collaborative Centre and GA2LEN Collaborative Centre

"¢ Professor at the Medical Faculty, University "St. Cyril and Methodius" Skopje


Scientific field of interest

"¢ Chronic obstructive airway diseases, functional lung diagnostics, occupationally-related respiratory and allergic diseases


Research activities

"¢ Researcher (co-operator) of the long-term scientific project funded by Ministry of Education and Science "Epidemiology of Allergic Rhinitis in the Republic of Macedonia in Correlation with Pollen Microflora" (2001-2003);

"¢ Co-operator of the Regional HESME Workshop "Work-Related Diseases" (June 2003);

"¢ Investigator in a phase III, parallel, comparative, partially blinded, placebo-controlled study on the efficacy and safety of FORMOTEROL SMB AXAHALERR DPI 12 mg and FORADILR AEROLIZERR DPI 12 mg in patients with moderate persistent asthma sponsored by Laboratoires SMB S.A. Belgium (November 2006 – May 2007);

"¢ Investigator in a phase III, randomized, parallel group study on the efficacy and safety of SMB BUDESONIDE-SALMETEROL DPI capsule 150/25μg BID delivered by the AXAHALER® versus SYMBICORT® TURBUHALER® 200/12μg BID in patients with moderate to severe persistent asthma (February 2009-March 2010);

"¢ Researcher in the GA2LEN survey and Survey Follow up Study from the Skopje centre (November 2007 – August 2010);

"¢ Nominated represent by Ministry of Health of R. Macedonia in the activities of the WHO Regional Office for Europe aimed at the development of national programmes for the elimination of asbestos-related diseases (ARDs) (June 2011-to date);

"¢ Member of the Management Committee of the COST Action TDI 1206 Development and Implementation of European Standards on Prevention of Occupational Skin Diseases (StanDerm);    

"¢ Investigator in a HZC113782: A Clinical Outcomes Study to compare the effect of Fluticasone Furoate/Vilanterol Inhalation Powder 100/25mcg with placebo on Survival in Subjects with Moderate Chronic Obstructive Pulmonary Disease (COPD) and a history of or at increased risk for cardiovascular disease (March 2012 – to date).


Member of Editorial Boards

"¢ Member of the Editorial Board of the American Journal of Immunology and Global Journal of Allergy



"¢ Member of the Editorial Board and one of the authors of the monograph "Allergic Diseases in R. Macedonia", ed. V. Cvetanov; Skopje, 2006

"¢ Author of the monograph "Lung and Pleural Diseases Related to Occupational Exposures"; Skopje, 2009

"¢ Author of the monograph "Spirometry"; Skopje 2010

"¢ One of the authors of the monograph "Occupational Medicine", ed. J. Karadzinska-Bislimovska; Skopje 2011

"¢ Author of the monograph "Smoking among Macedonian Workers"; Saarbrí¼cken 2013

"¢ Author and co-author of more than 150 papers published in domestic and international journals



International: European Respiratory Society, EuropeanAcademy of Allergology and Clinical Immunology, World Allergy Organization

National: Macedonian Respiratory Society, Macedonian Society of Basic and Clinical Immunology and Allergology, Macedonian Society of Occupational Medicine Specialists


 Languages spoken: English (fluent), German (less fluent)


Computer Literacy: Good


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