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Intravenous N-acetylcysteine in respiratory disease with abnormal mucus secretion.
Tang, W; Zhu, D; Wu, F; Xu, J-F; Yang, J-P; Deng, Z-P; Chen, X-B; Papi, A; Qu, J-M.
Afiliação
  • Tang W; Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. jmqu0906@163.com.
Eur Rev Med Pharmacol Sci ; 27(11): 5119-5127, 2023 Jun.
Article em En | MEDLINE | ID: mdl-37318485
ABSTRACT

OBJECTIVE:

Evidence for the mucolytic and expectorant efficacy of intravenous (IV) N-acetylcysteine (NAC) is limited. This study aimed to evaluate in a large, multicenter, randomized, controlled, subject, and rater-blinded study whether IV NAC is superior to placebo and non-inferior to ambroxol in improving sputum viscosity and expectoration difficulty. PATIENTS AND

METHODS:

A total of 333 hospitalized subjects from 28 centers in China with respiratory disease (such as acute bronchitis, chronic bronchitis and exacerbations, emphysema, mucoviscidosis, and bronchiectasis) and abnormal mucus secretion were randomly allocated in a 111 ratio to receive NAC 600 mg, ambroxol hydrochloride 30 mg, or placebo as an IV infusion twice daily for 7 days. Mucolytic and expectorant efficacy was assessed by ordinal categorical 4-point scales and analyzed by stratified and modified Mann-Whitney U statistics.

RESULTS:

NAC showed consistent and statistically significant superiority to placebo and non-inferiority to ambroxol in change from baseline to day 7 in both sputum viscosity scores [mean (SD) difference 0.24 (0.763), p<0.001 vs. placebo] and expectoration difficulty score [mean (SD) difference 0.29 (0.783), p=0.002 vs. placebo]. Safety findings confirm the good tolerability profile of IV NAC reported from previous small studies, and no new safety concerns were identified.

CONCLUSIONS:

This is the first large, robust study of the efficacy of IV NAC in respiratory diseases with abnormal mucus secretion. It provides new evidence for IV NAC administration in this indication in clinical situations where the IV route is preferred.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtornos Respiratórios / Ambroxol Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Humans Idioma: En Revista: Eur Rev Med Pharmacol Sci Assunto da revista: FARMACOLOGIA / TOXICOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtornos Respiratórios / Ambroxol Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Humans Idioma: En Revista: Eur Rev Med Pharmacol Sci Assunto da revista: FARMACOLOGIA / TOXICOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: China
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