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Efficacy of N-Acetylcysteine in Idiopathic Pulmonary Fibrosis: A Systematic
Review and Meta-Analysis
#MMPMID27175674
Sun T
; Liu J
; Zhao W
Medicine (Baltimore)
2016[May]; 95
(19
): e3629
PMID27175674
show ga
There are a number of conflicting reports describing the clinical outcomes of
using N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis. We
have, therefore, performed a meta-analysis to evaluate the efficacy of
N-acetylcysteine, compared with control, for the treatment of idiopathic
pulmonary fibrosis.Original controlled clinical trials evaluating the efficacy of
N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis were included
in the analysis. Searches for relevant articles were carried out in July 2014 by
2 independent researchers using PubMed, Embase, Cochrane Central, and Google
Scholar. Change in forced vital capacity, change in percentage of predicted vital
capacity, change in percentage of predicted carbon monoxide diffusing capacity,
changes in 6?minutes walking test distance, rate of adverse events, and rate of
death were expressed as outcomes using RevMan 5.0.1.Five trials, with a total of
564 patients, were included in this meta-analysis. The meta-analysis showed that
the control group had significant decreases in percentage of predicted vital
capacity (standardized mean difference [SMD]?=?0.37; 95% confidence interval
[CI]: 0.13 to -0.62; P?=?0.003) and 6?minutes walking test distance (SMD?=?0.25;
95% CI: 0.02-0.48; P?=?0.04). There were no statistically significant differences
in forced vital capacity (SMD?=?0.07; 95% CI: -0.13-0.27; P?=?0.52), percentage
of predicted carbon monoxide diffusing capacity (SMD?=?0.12; 95% CI: -0.06-0.30;
P?=?0.18), rates of adverse events (odd ratio?=?4.50; 95% CI: 0.19-106.41;
P?=?0.35), or death rates (odd ratio?=?1.79; 95% CI: 0.3-5.12; P?=?0.28) between
the N-acetylcysteine group and the control group.N-Acetylcysteine was found to
have a significant effect only on decreases in percentage of predicted vital
capacity and 6 minutes walking test distance. N-acetylcysteine showed no
beneficial effect on changes in forced vital capacity, changes in predicted
carbon monoxide diffusing capacity, rates of adverse events, or death rates.
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