Breakthrough for breathing

Drug may drive away chronic bronchitis

The best that medicine has to offer is about to get better, at least for people with chronic bronchitis. An inhaled drug may cut the risk of death by more than half for people who have to be hospitalized when a flare-up hits. Doctors can control occasional bronchitis outbreaks in healthy people (with fluids and sometimes antibiotics), but chronic bronchitis isn't so easy.

It comes not only with the stuff in the lungs that you get with regular bronchitis, but also with airways that are so inflamed it's difficult to clear the lungs. Inflammation of the airways is often a result of smoking for more than 10 years.

Until now, scientists have been using antibiotics and bronchodilators to get the lungs back to normal, but still one in six people hospitalized with chronic bronchitis dies within three months of the episode.

But that may change with a drug called DNase, or dornase alfa (marketed as Pulmozyme). In a recent trial with 244 chronic-bronchitis patients, itreduced deaths by 59percent over the standard-care group, according to a preliminary study presented at the Clinical ResearchMeeting in Baltimore,in May. The drug alsowas able to reduce inci-dence of relapse andrehospitalization.

The drug, currently used for cystic fibrosis, mimics an enzyme that's already in the body. It cuts through the thick secretions in the lungs, which are partly made of piled-up DNA from white blood cells that have died in the task of fighting the infection. Cutting through the pileups allows a patient to clear them from the lungs and breathe easier, says Henry J. Fuchs, M.D., one of the developers of the drug.

"I think a lot of people are surprised about how serious this disease can be," says Dr. Fuchs. "Something that dramatically reduces the chance of dying is really a breakthrough in medicine." He and his team are currently working on a large trial of the drug that could lead to rapid FDA approval of it for this use.

PHOTO: Lungs

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By Marty Munson with Beth Higbee

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