Treatment with the immunomodulator AM3 improves the health-related quality of life of patients with COPD.
BACKGROUND
COPD has a severe impact on patient quality of life. AM3 is an orally effective immunomodulator that can normalize the defective antimicrobial functions of the immune system effector cells of COPD patients.


OBJECTIVE
We analyzed the effect of AM3 on exacerbation frequency and health-related quality of life (HRQL) of COPD patients with moderate disease.


METHODS
A randomized, double-blind, placebo-controlled trial.


METHODS
Outpatient departments of 21 hospitals.


METHODS
A total of 253 COPD patients with a mean age of 67.7 years (SD, 8.1 years) and mean FEV(1) percentage of predicted of 49.6% (SD, 10.2%) were evaluated. Patients received (orally) either 3 g/d AM3 or a matched placebo for 180 consecutive days. Patient quality of life was measured using the St. George's Respiratory Questionnaire (SGRQ).


RESULTS
There were no differences in the exacerbation frequency of the two groups (0.82 episodes per patient in the AM3 arm vs 0.84 in the placebo arm), and 55.3% of patients were exacerbation free in the AM3 arm compared to 48.8% in the placebo arm (p = 0.11). At the end of treatment, quality of life was significantly better in the AM3 arm than in the placebo arm (SGRQ total score, 32.9; SD, 16.4, compared to 37.5; SD, 17.5 [p < 0.05]: activity score, 47.5; SD, 22.4, compared to 54.6; SD, 20.5 [p < 0.05]). The improvements in total SGRQ scores were 8.9 U (SD, 13.4 U) in the AM3 arm and 5.6 U (SD, 15.9 U) in the placebo arm (p = 0.076). Improvements on the symptoms subscale were 15.9 U (SD, 20.7 U) for the AM3 arm and 10.2 U (SD, 21.3 U) for the placebo arm (p < 0.05). Both AM3 and the placebo were clinically, biochemically, and hematologically well tolerated.


CONCLUSIONS
AM3 is a safe, easily tolerated, effective treatment that improves the quality of life of COPD patients as measured by SGRQ scores. This effect was observed with no significant reduction in the frequency of exacerbations.
Alvarez-Mon
Melchor
M
Departmento de Medicina, Universidad de Alcalá, Carretera Madrid-Barcelona, Km 33,600, E-28871 Alcalá de Henares (Madrid), Spain. mams@tsai.es
Miravitlles
Marc
M
Morera
Josep
J
Callol
Luis
L
Alvarez-Sala
José L
JL
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006020:Glycopeptides / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D011788:Quality of Life; D018434:Sickness Impact Profile
D000276:Adjuvants, Immunologic; D002130:Calcium Phosphates; D006020:Glycopeptides; C038773:Immunoferon