Evidence supporting the use of: N-acetylcysteine
For the health condition: Chronic Obstructive Pulmonary Disorder

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Synopsis

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

N-acetylcysteine (NAC) is used in the management of Chronic Obstructive Pulmonary Disease (COPD) primarily due to its mucolytic and antioxidant properties. Scientifically, NAC acts by breaking disulfide bonds in mucus, thereby reducing its viscosity and making it easier to expectorate. Additionally, NAC serves as a precursor to glutathione, a critical intracellular antioxidant, which may help reduce oxidative stress associated with COPD pathogenesis and exacerbations.

Clinical evidence for NAC’s efficacy in COPD is mixed but generally suggests some benefit. Several randomized controlled trials and meta-analyses (such as those published in Chest and the Cochrane Database) have shown that long-term oral NAC can modestly reduce the frequency of COPD exacerbations, especially in patients not already taking inhaled corticosteroids. The effect on lung function, quality of life, and symptom scores is less clear, with studies showing inconsistent or modest improvements.

International guidelines, such as those from the Global Initiative for Chronic Obstructive Lung Disease (GOLD), mention NAC as a potential adjunct for patients with frequent exacerbations, though they note that the quality of evidence is moderate and that benefit appears most pronounced at higher doses and in specific subgroups. Overall, while not universally recommended as standard therapy, NAC’s use in COPD is scientifically supported for reducing exacerbation frequency, though its impact on other clinical outcomes is limited.

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Products containing N-acetylcysteine

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