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N-acetylcysteine Treatment in Chronic Obstructive Pulmonary Disease (COPD) and Chronic Bronchitis/Pre-COPD: Distinct Meta-analyses.
Papi, Alberto; Alfano, Franco; Bigoni, Tommaso; Mancini, Lorenzo; Mawass, Amal; Baraldi, Federico; Aljama, Cristina; Contoli, Marco; Miravitlles, Marc.
Afiliação
  • Papi A; Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Ferrara, Italy. Electronic address: ppa@unife.it.
  • Alfano F; Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Ferrara, Italy.
  • Bigoni T; Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Ferrara, Italy.
  • Mancini L; Alira Health S.r.l., 20121 Milan, Italy.
  • Mawass A; Alira Health S.r.l., 20121 Milan, Italy.
  • Baraldi F; Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Ferrara, Italy.
  • Aljama C; Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
  • Contoli M; Department of Translational Medicine, University of Ferrara Medical School, University of Ferrara, Sant'Anna University Hospital, Ferrara, Italy.
  • Miravitlles M; Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
Arch Bronconeumol ; 60(5): 269-278, 2024 May.
Article em En, Es | MEDLINE | ID: mdl-38555190
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Acetilcisteína / Qualidade de Vida / Bronquite Crônica / Doença Pulmonar Obstrutiva Crônica Limite: Humans Idioma: En / Es Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Acetilcisteína / Qualidade de Vida / Bronquite Crônica / Doença Pulmonar Obstrutiva Crônica Limite: Humans Idioma: En / Es Ano de publicação: 2024 Tipo de documento: Article