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Drugs to control the movement of salt in the lungs of people with cystic fibrosis

Burrows EF, Southern KW, Noone PG
Published Online: 
9 April 2014

Usually salt is absorbed from liquid on the surface of the lungs to stop fluid building up there. In cystic fibrosis too much salt is absorbed and there is little liquid left on the airway surfaces. As a result people with cystic fibrosis have problems clearing their lungs of sticky secretions. Thus the lungs are left open to infection. Drugs applied directly to the lungs may prevent too much salt being absorbed. This may lead to better clearance of mucus and less lung infection and damage. The review includes five studies with a total of 226 participants. All studies looked at short-acting drugs applied directly to the lungs compared to placebo. When the results from three studies over six months were combined, the placebo group showed a slower rate of decline in forced vital capacity than the treatment group. However, each of these differed in their results. A further study showed that people receiving a sodium channel blocker before receiving hypertonic saline did not achieve better lung function or mucus clearance than those receiving placebo before hypertonic saline. We found no evidence that short-acting sodium channel blockers administered directly to the lungs improve respiratory status in people with cystic fibrosis. There was even some limited evidence of a decline in lung function. Trials of long-acting sodium channel blockers are ongoing.

This record should be cited as: 
Burrows EF, Southern KW, Noone PG. Sodium channel blockers for cystic fibrosis. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD005087. DOI: 10.1002/14651858.CD005087.pub4
Assessed as up to date: 
3 April 2014