Evidence supporting the use of: N-acetyl-cysteine (NAC)
For the health condition: Chronic Obstructive Pulmonary Disorder

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

N-acetyl-cysteine (NAC) is used as an adjunct therapy in Chronic Obstructive Pulmonary Disease (COPD), and its use is supported by scientific evidence, particularly for its mucolytic and antioxidant properties. NAC acts as a precursor to glutathione, a key antioxidant in the lungs, and helps reduce oxidative stress, which is a significant component of COPD pathophysiology. Additionally, NAC has mucolytic activity, meaning it helps to break down mucus, making it easier for patients to clear respiratory secretions.

Several clinical studies and meta-analyses have evaluated the efficacy of NAC in COPD. Some randomized controlled trials and systematic reviews (e.g., Cochrane Reviews) have shown that regular use of NAC at doses of 600 mg daily or more can reduce the frequency of COPD exacerbations, especially in patients with moderate to severe disease and a history of frequent exacerbations. The benefits are most pronounced in patients not already on inhaled corticosteroids. However, the degree of improvement in lung function and symptom relief is modest, and not all studies have shown consistent results.

Overall, while NAC is included in some clinical guidelines as an option for specific COPD patients, especially those with chronic bronchitis and frequent exacerbations, its use is not universally recommended. The evidence supports a moderate benefit, leading to a rating of 3/5 for the strength of evidence. Ongoing research continues to clarify which patient populations benefit most from NAC supplementation.

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