Journal Information
Vol. 60. Issue 5.
Pages 269-278 (May 2024)
Share
Share
Download PDF
More article options
Vol. 60. Issue 5.
Pages 269-278 (May 2024)
Original Article
N-acetylcysteine Treatment in Chronic Obstructive Pulmonary Disease (COPD) and Chronic Bronchitis/Pre-COPD: Distinct Meta-analyses
Visits
903
Alberto Papia,
Corresponding author
ppa@unife.it

Corresponding author.
, Franco Alfanoa, Tommaso Bigonia, Lorenzo Mancinib, Amal Mawassb, Federico Baraldia, Cristina Aljamac, Marco Contolia, Marc Miravitllesc
a Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant’Anna University Hospital, Ferrara, Italy
b Alira Health S.r.l., 20121 Milan, Italy
c Pneumology Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
Highlights

  • Treatment effects on PROs in chronic bronchitis (CB) with/out COPD are scarcely known.

  • N-acetylcysteine (NAC) improve symptoms and/or QoL in studies conducted in CB.

  • NAC reduce exacerbations in studies conducted in subjects with CB.

  • Similarly, NAC reduce exacerbations and improve symptoms and/or QoL in COPD studies.

This item has received
Disponible módulo formativo: . Saber más
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (6)
Show moreShow less
Additional material (1)
Abstract
Introduction

N-acetylcysteine (NAC) is a mucolytic agent with antioxidant properties. Oxidative stress is a key pathogenic mechanism in chronic respiratory conditions such as COPD and chronic bronchitis (CB). In these meta-analyses we investigated the efficacy of NAC in subjects with COPD or CB, the latter being a potential pre-COPD condition (CB/pre-COPD).

Methods

The meta-analyses were conducted according to PRISMA guidelines. Exacerbations were assessed using total number of exacerbations. Improvement in patients’ respiratory symptoms and/or patients quality of life (QoL) were measured by validated tools or assessed at the end of the study.

Results

Twenty studies were included, of which seven evaluated NAC in patients with symptoms of CB/pre-COPD as entry criterion.

NAC treated patients showed a significant reduction of the incidence of exacerbations as compared to placebo both in COPD (IRR=0.76; 95% confidence interval (CI) 0.59–0.99) and CB/pre-COPD (IRR=0.81; 95% CI 0.69–0.95). Sensitivity analyses in studies with duration higher than 5 months, confirmed the overall results.

CB/pre-COPD patients treated with NAC were significantly more likely to experience an improvement in symptoms and/or QoL compared to placebo (odds ratio (OR)=3.47; 95% CI 1.92–6.26). A similar trend was observed in the few COPD studies evaluable.

Sensitivity analyses showed a significant association of NAC with improvement in symptoms and/or QoL both in CB/pre-COPD and COPD patients.

Conclusions

These findings provide novel data of NAC on the improvement in symptoms and QoL in addition to prevention of exacerbations in COPD and CB/pre-COPD.

PROSPERO registry no. CRD42023468154.

Keywords:
NAC
PROs
Chronic bronchitis
COPD
Meta-analysis

Article

These are the options to access the full texts of the publication Archivos de Bronconeumología
Member
If you are a member of SEPAR:
  • Go to >>>SEPAR<<< website and sign in.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Archivos de Bronconeumología

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?