N-Acetylcysteine in Chronic Bronchitis or COPD Exacerbations

A meta-analysis 1 on the role of N-acetylcysteine (NAC) in the treatment of patients with chronic bronchitis and chronic obstructive pulmonary disease (COPD) included 13 studies with a total of 4 155 subjects. Patients treated with NAC had significantly and consistently fewer exacerbations (RR 0.75, 95% CI 0.66 to 0.84). This protective effect was more apparent in patients without evidence of airway obstruction. However, high doses of NAC were also effective in patients suffering from COPD diagnosed using spirometric criteria (RR 0.75, 95% CI 0.68 to 0.82).

NAC was well tolerated. The risk of adverse reactions, mainly gastrointestinal disorders, was not dose-dependent.

The following decision support rules contain links to this evidence summary:

• Drugs for preventing frequent exacerbations in COPD http://www.ebmeds.org/ebmeds/ebmeds_home.asp?mode=scripts&submode=view&id=scr00534&country=UK

References

• Cazzola M, Calzetta L, Page C et al. Influence of N-acetylcysteine on chronic bronchitis or COPD exacerbations: a meta-analysis. Eur Respir Rev 2015;24(137):451-61. [PubMed]