{
  "abstract": "Background and objective\n\nBreathlessness is a leading cause of disability and reduced quality of life in COPD. Inhaled l-menthol may reduce breathlessness but data on its effect on exertional breathlessness is limited. We aimed to evaluate the effect of inhaled l-menthol on exertional breathlessness and exercise capacity in patients with COPD.Methods\n\nThis was a double-blinded, randomised (ratio 1:1), crossover trial (RCT) of l-menthol inhalation versus placebo. 20 participants with COPD performed two constant-load cycle cardiopulmonary exercise tests (CPET) to exhaustion, with either l-menthol or placebo (strawberry) scented patch in the mask in randomised order. The primary outcome was the difference in breathlessness intensity (Borg 0-10 scale) at isotime. Secondary outcomes were change in breathlessness unpleasantness and leg fatigue at isotime, exercise endurance time (EET), exertional physiological responses and multidimensional breathlessness (MDP).Results\n\nCompared with placebo, inhaled l-menthol reduced breathlessness intensity at isotime (mean difference -0.8, 95% CI -1.6-0.0; p=0.042), corresponding to a moderate effect size (Cohen's d= -0.49). Isotime breathlessness unpleasantness (-0.7, -1.7-0.3) and emotional response score was lower with L-menthol (-2.2, -4.4-0.0). Leg discomfort (-0.5, -1.3-0.2) was numerically lower, EET was longer (0.9 min, -0.7-2.5) and physiological responses were unchanged.Conclusion\n\nInhalation of l-menthol reduced the intensity and emotional response of exertional breathlessness and increased the EET compared with placebo in patients with COPD. The unchanged physiological responses support a central brain effect and l-menthol might be a promising new treatment.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.",
    "Department of Clinical Sciences in Lund, Division of Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden.",
    "Clinical Physiology, Department of Clinical Sciences, Lund University, Lund, Sweden.",
    "Department of Clinical Physiology, Skåne University Hospital, Lund, Sweden.",
    "Clinical Studies Sweden-Forum South, Skåne University Hospital, Lund, Sweden."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Jacob Sandberg",
      "orcid": "0000-0003-1863-2033"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Henrik Mosen",
      "orcid": "0000-0002-6237-9082"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Magnus Ekström",
      "orcid": "0000-0002-7227-5113"
    },
    {
      "affs": [
        4
      ],
      "name": "Sara Jesperson"
    },
    {
      "affs": [
        1
      ],
      "name": "Zainab Ahmadi",
      "orcid": "0000-0003-1434-5715"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cpjg4xm5sjfn8.bib",
  "cited_by": 0,
  "doi": "10.1183/23120541.00495-2026",
  "fulltext_url": "https://europepmc.org/articles/PMC13678658",
  "id": "cpjg4xm5sjfn8",
  "issns": [
    "2312-0541"
  ],
  "landing_url": "https://europepmc.org/article/MED/42899053",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Chronic Obstructive Pulmonary Disease (COPD) Research"
    ]
  ],
  "openalex": "W7170138121",
  "pdf_url": "https://europepmc.org/articles/PMC13678658?pdf=render",
  "pmcid": "PMC13678658",
  "pmid": "42899053",
  "published": "2026-09-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cpjg4xm5sjfn8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:41Z",
      "native_id": "MED:42899053",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42899053"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Chronic Obstructive Pulmonary Disease (COPD) Research",
      "subfield": "general"
    }
  ],
  "title": "Effect of l-menthol on breathlessness and exercise endurance in COPD: a randomised crossover trial.",
  "title_text": "Effect of l-menthol on breathlessness and exercise endurance in COPD: a randomised crossover trial.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:41Z",
  "url": "https://research.draconitic.com/paper/cpjg4xm5sjfn8",
  "venue": "ERJ open research",
  "versions": []
}