Is N-acetylcysteine effective in the treatment of pulmonary fibrosis?
Idiopathic pulmonary fibrosis is a progressive chronic respiratory disease that in final stages carries high mortality. Several treatment options have been proposed, including N-acetylcysteine, but its role is not clearly established. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified eight systematic reviews including 16 trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded N-acetylcysteine might increase the risk of hospitalizations and exacerbations. While it is unclear whether this leads to increased mortality because the certainty of the evidence is very low, in general there is consensus that it should not be used except in the context of a new clinical trial.
Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Departamento de Medicina Interna, Hospital de Los Ángeles, Los Ángeles, Región del Biobío, Chile. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro Chile. Email: glabarcat@gmail.com.
Alejandro
A
Jeldres Pulgar
Departamento de Medicina Interna, Hospital de Los Ángeles, Los Angeles, Los Ángeles, Región del Biobío, Chile; Proyecto Epistemonikos, Santiago, Chile; Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Gonzalo
G
Labarca