Benefits of high dose N-acetylcysteine to exacerbation-prone COPD patients.

Link to article at PubMed

Benefits of high dose N-acetylcysteine to exacerbation-prone COPD patients.

Chest. 2014 May 15;

Authors: Tse HN, Raiteri L, Wong KY, Ng LY, Yee KS, Tseng CZ

ABSTRACT BACKGROUND: Although high-dose NAC has been suggested to reduce COPD exacerbations, it is unclear which category of COPD patients would benefit most from the NAC treatment.
OBJECTIVE: To compare the effect of high-dose NAC (600 mg twice daily) between 'high-risk' and 'low-risk' Chinese COPD patients METHODOLOGY: Spirometry-confirmed stable COPD patients were randomized to treatment with either NAC 600 mg twice daily or placebo, on top of their usual treatments. Patients were followed up at every 16 weeks for a total of 1 year. Further analysis was performed according to patient's exacerbation risk at baseline as defined by the current GOLD strategy for classification of exacerbation risk (high-risk vs. low-risk group) so as to analyze the effect of high-dose NAC in high-risk and low-risk patients.
RESULTS: Of 120 COPD patients randomized (93.2% male, mean age of 70.8 ± 0.74 and pre-bronchodilator %FEV1 53.9 ± 2.0%, baseline characteristics were comparable between the treatment groups), 108 patients (NAC n=52; placebo n=56) completed the 1-year study. For high-risk patients (n=89), high-dose NAC significantly reduced exacerbation frequency (0.85 vs. 1.59, p=0.019*; 1.08 vs. 2.22, p=0.04* at 8 and 12 months, respectively), prolonged time-to-first exacerbation (p=0.02*) and increased the probability of being exacerbation-free at 1 year (51.3% vs. 24.4%, p=0.013*) compared with placebo. This beneficial effect of high-dose NAC versus placebo was not significant in low-risk patients.
CONCLUSION: High-dose NAC (600 mg twice daily for 1 year) reduces exacerbations, and prolongs time to first exacerbation in high-risk but not in low-exacerbation risk Chinese COPD patients.( ID: NCT01136239).

PMID: 24833327 [PubMed - as supplied by publisher]

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