2026-04-13T13:28:34Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/114762025-10-24T08:57:06Zcom_2072_378070com_2072_378040com_2072_378071col_2072_378092col_2072_378097
RECERCAT
author
PAPI, ALBERTO
author
Alfano, Franco
author
Bigoni, Tommaso
author
MANCINI, LORENZO
author
Mawass, Amal
author
BARALDI, FEDERICO
author
ALJAMA, CRISTINA
author
Miravitlles, Marc
2025-10-24T08:57:06Z
2025-10-24T08:57:06Z
2024-05-21T07:12:19Z2024-05-21T07:12:19Z2024-05
http://hdl.handle.net/11351/11476
COPD; Chronic bronchitisEPOC; Bronquitis crónicaMPOC; Bronquitis crònicaIntroduction
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.Statistical and editorial support was provided by Zambon S.p.A.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Avaluació de resultats (Assistència sanitària)
Pulmons - Malalties obstructives - Tractament
Mucolítics - Ús terapèutic
DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
Other subheadings::Other subheadings::Other subheadings::/drug therapy
CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Respiratory System Agents::Expectorants
Other subheadings::Other subheadings::/therapeutic use
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome
ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos del sistema respiratorio::expectorantes
Otros calificadores::Otros calificadores::/uso terapéutico
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento
N-acetylcysteine Treatment in Chronic Obstructive Pulmonary Disease (COPD) and Chronic Bronchitis/Pre-COPD: Distinct Meta-analyses
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion