title: The effect of N-acetylcysteine on exacerbations of chronic obstructive pulmonary disease: A meta-analysis and systematic review.
abstract: N-acetylcysteine (NAC) is an antioxidant and anti-inflammatory. Its effects on chronic obstructive pulmonary (COPD) outcomes, including exacerbation of and changes in lung function parameters, are controversial. To investigate the effects of NAC on COPD exacerbation and changes in lung function parameters in patients with COPD. A meta-analysis of randomized controlled trials retrieved from PubMed and Medline databases (12 trials; 2691 patients). High-dose [relative ratio (RR) = 0.90, 95% confidence interval (CI) = 0.82-0.996, P = 0.041] and low-dose (RR = 0.83, 95% CI = 0.69-0.99, P = 0.043) NAC reduced COPD exacerbation prevalence. Long-term (≥6 months), but not short-term, NAC reduced exacerbation prevalence (RR = 0.85, 95% CI = 0.74-0.98, P = 0.024). NAC did not affect exacerbation rate, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), or inspiratory capacity (IC). Long-term NAC therapy may reduce risk of COPD exacerbation.
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, PR China.
authors.forename: Kaushal
authors.initials: K
authors.lastname: Fowdar
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, PR China.
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, PR China. Electronic address: zhiyi-river@163.com.
authors.forename: Zhiyi
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Respiratory Medicine, The First People's Hospital of Yulin City, Yulin 537000, PR China.
authors.forename: Jiujin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, PR China.
authors.forename: Xiaoning
authors.initials: X
authors.lastname: Zhong
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, PR China.
authors.forename: Jianquan
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, PR China.
authors.forename: Meihua
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, PR China.
authors.forename: Jing
authors.initials: J
authors.lastname: Bai
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005541:Forced Expiratory Volume / Q000187:drug effects; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007320:Inspiratory Capacity / Q000187:drug effects; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000893:Anti-Inflammatory Agents; D016166:Free Radical Scavengers; D000111:Acetylcysteine
keywords: Chronic obstructive pulmonary disease; Effect; Exacerbation; Meta-analysis; N-acetylcysteine