N-Acetylcysteine for Treating Patients with COPD — A Randomized Trial

Allan S. Brett, MD

The drug improved airway mechanics and prevented recurrent exacerbations among patients with chronic obstructive pulmonary disease.

Because of its antioxidant effects, N-acetylcysteine (NAC) has been proposed as an adjunctive treatment for patients with chronic obstructive pulmonary disease (COPD). In this study, Hong Kong researchers randomized 120 patients with stable COPD who averaged two exacerbations and one COPD hospitalization during the previous year to receive either NAC (600-mg tablets, taken twice daily) or placebo.

At 1 year, measures of airway reactance and resistance improved significantly in the NAC group but not in the placebo group. COPD exacerbations occurred less often with NAC than with placebo (mean, 0.96 vs. 1.71; P=0.02). The proportions of patients with no exacerbation during the study year were 54% in the NAC group and 38% in the placebo group (P=0.09). No major adverse effects were reported.

Citation(s):

Tse HN et al. High-dose N-acetylcysteine in stable COPD: The 1-year, double-blind, randomized, placebo-controlled HIACE study. Chest 2013 Jul; 144:106.