Carbocisteine, gingko leaf extract boost milrinone’s efficacy against COPD complicated by PAH

The combination of carbocisteine, gingko leaf extract, and milrinone yields significant clinical improvement in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), a recent study has found. In turn, this treatment regimen also leads to better patient quality of life.

The study included 120 patients (mean age 72.8±6.5 years, 87 men) with AECOPD complicated by pulmonary arterial hypertension (PAH), as confirmed by Doppler echocardiography. Participants were randomly assigned to receive the triple combination treatment or milrinone alone, with each arm having 60 patients.

In the control group, the pulmonary arterial systolic pressure (PASP) dropped from 68.53±9.07 mm Hg at baseline to 59.08±6.31 mm Hg after milrinone treatment. In comparison, PASP in patients who received the combination treatment decreased from 68.62±10.33 mm Hg at baseline to 52.77±6.12 mm Hg. Post-treatment PASP was significantly lower in the treatment vs control arm (p<0.05).

In turn, despite comparable PASP at baseline (p>0.05), AECOPD patients who received the triple-drug combo saw a significantly greater improvement rate than milrinone-only comparators (40.67±5.3 percent vs 33.52±3.2 percent, respectively; p<0.05).

“Gingko leaf extract has an effective component that is primarily composed of flavonoids, which can protect capillary permeability, dilate the coronary artery, restore arterial elasticity, and nourish the cerebral cells and other organs,” the researchers explained. “Gingko leaf extract has a good effect in reducing blood pressure by increasing the permeability and elasticity of the blood vessels.”

Meanwhile, carbocisteine is an expectorant mainly affecting bronchial glands, they added. Such properties could explain why both compounds improved the clinical efficacy of milrinone against COPD, a respiratory condition often characterized by the hypersecretion airway mucus.