Home›Drug Pipeline› Andrographolide derivative injections improve clinical response and pulmonary function in patients with AECOPD
Andrographolide derivative injections improve clinical response and pulmonary function in patients with AECOPDAndrographolide Injections May Improve Clinical Response in COPD Flare-ups
Frontiers in MedicinePublished September 24, 2026DOI ↗Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development
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Key Takeaway
Consider andrographolide derivatives as an adjunctive therapy to improve clinical response and lung function in AECOPD.
This meta-analysis evaluated the efficacy of andrographolide derivative injections (such as Xiyanping, Yanhuning, Chuanhuning, and Lianbizhi) as an adjunctive therapy for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The analysis included 2,668 patients and compared the combination therapy against conventional therapy alone.
The meta-analysis reported a statistically significant improvement in overall clinical response (RR 1.21; 95% CI 1.17 to 1.26, P < 0.00001). Pulmonary function markers also showed improvement, including FEV1% (MD 6.48; 95% CI 3.52 to 9.45), FEV1 (MD 0.30 L; 95% CI 0.20 to 0.40), FVC (MD 0.28 L; 95% CI 0.10 to 0.46), and PaO2 (MD 6.56 mmHg; 95% CI 4.68 to 8.45). Additionally, inflammatory markers were reduced, including CRP (MD -4.72 mg/L), WBC (MD -1.30 x 10^9/L), NEUT% (MD -4.36 percentage points), and PCT (MD -0.17 ng/mL).
Limitations noted by the authors include the fact that the included studies were exclusively Chinese single-center RCTs and there was substantial heterogeneity in some outcomes. Furthermore, there is a lack of direct mechanistic data on individual derivatives. Clinical application should be tempered by these limitations and the lack of safety data reported in the analysis.
How this fits prior evidence
This meta-analysis addresses a gap in the management of AECOPD by evaluating andrographolide derivatives as an adjunctive therapy. While the study suggests improvements in pulmonary function and inflammatory markers, it does not directly relate to the previously reported findings on inhaled treprostinil for IPF or the risk markers for pulmonary embolism. It provides a specific look at adjunctive pharmacological options for AECOPD, though it notes that other targeted therapies for COPD are currently investigational with no reported efficacy or safety data.
A review of data involving 2,668 patients looked at the effects of andrographolide derivative injections when added to standard treatment for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The study focused on whether these injections could improve clinical response, lung function, and oxygen levels.
The findings showed that patients receiving the injections alongside standard care had better overall clinical responses compared to those receiving standard care alone. Specifically, the data showed improvements in lung function measures like FEV1 and FVC, as well as better oxygen levels (PaO2). The treatment also showed a link to lower levels of inflammatory markers in the blood.
Because this data comes from a meta-analysis of single-center trials in China, the results may not apply to all patients everywhere. There is also a lack of specific information on how each individual derivative works. These findings are currently used to suggest a potential benefit, but they do not replace standard medical advice or proven treatments.
What this means for you:
Andrographolide injections may improve lung function and inflammation in COPD flare-ups, but results are limited.
Common questions
What is andrographolide and how is it used for COPD?
Andrographolide is a compound found in certain plants. In this study, it was administered as a derivative injection. It was used as an addition to standard medical treatment for patients experiencing acute exacerbations of chronic obstructive pulmonary disease (AECOPD).
Does this treatment improve lung function?
The study showed that patients receiving andrographolide injections along with standard care had improved lung function measurements, including FEV1 and FVC. It also showed an increase in PaO2, which relates to oxygen levels in the blood.
Are there any known side effects from these injections?
The provided data did not report any specific adverse events, serious side effects, or issues with how well the treatment was tolerated by the patients. You should consult your doctor regarding specific safety concerns.
BackgroundAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) contributes substantially to morbidity and mortality. Andrographolide derivative injections (e.g., Xiyanping, Yanhuning, Chuanhuning, Lianbizhi) are widely used adjunctive treatments in China. Their clinical efficacy remains unclear, and we explored the potential mechanisms of the parent compound andrographolide in this study.MethodsA systematic review and meta-analysis of 32 randomized controlled trials (n = 2,668) comparing andrographolide derivatives plus conventional therapy versus conventional therapy alone in patients with AECOPD was conducted. Pulmonary function (FEV1%, FEV1, FVC), arterial oxygen tension (PaO2), inflammatory markers (CRP, WBC, NEUT%, PCT), and overall clinical response were evaluated. Network pharmacology, molecular docking, and in vitro experiments using LPS-stimulated BEAS-2B cells were performed to explore underlying mechanisms.ResultsAdjunctive andrographolide derivatives significantly improved overall clinical response rate [RR = 1.21, 95% CI 1.17–1.26, P < 0.00001], FEV1% [MD = 6.48, 95% CI 3.52–9.45], FEV1 [MD = 0.30 L, 95% CI 0.20–0.40], FVC [MD = 0.28 L, 95% CI 0.10–0.46], and PaO2 [MD = 6.56 mmHg, 95% CI 4.68–8.45]. Inflammatory markers were also reduced: CRP [MD = −4.72 mg/L, 95% CI -6.83 to –2.61], WBC [MD = −1.30 ×109/L, 95% CI −1.79 to −0.80], NEUT% [MD = −4.36 percentage points, 95% CI -6.18 to −2.54], PCT [MD = −0.17 ng/mL, 95% CI -0.23 to −0.10] (all P < 0.0001). Network pharmacology identified 39 overlapping targets, highlighting TNF, IL-1β, NLRP3, and CASP1 as core targets. Molecular docking suggested energetically favorable predicted interactions of andrographolide with NLRP3, caspase-1, IL-1β, and IL-18. In vitro, andrographolide enhanced BEAS-2B cell viability, reduced LDH release, and suppressed NLRP3, caspase-1, IL-1β, and TNF-α expression.ConclusionAndrographolide derivative injections as adjunctive therapy may improve clinical response, pulmonary function, oxygenation, and inflammatory status in patients with AECOPD. Mechanistic experiments using the parent compound andrographolide suggest that these therapeutic effects are potentially mediated by the NLRP3/caspase-1/IL-1β inflammatory axis. Nevertheless, these findings should be interpreted cautiously given the exclusively Chinese single-center RCTs, substantial heterogeneity in some outcomes, and lack of direct mechanistic data on individual derivatives.
