Evidence supporting the use of: N-acetyl-cysteine (NAC)
For the health condition: Fibrosis

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

N-acetyl-cysteine (NAC) has been investigated for its potential role in treating or supporting fibrosis, particularly pulmonary fibrosis, due to its antioxidant properties and ability to replenish intracellular glutathione. Scientific interest in NAC for fibrosis arises from the role of oxidative stress and inflammation in the pathogenesis of fibrotic diseases. In idiopathic pulmonary fibrosis (IPF), some early studies and small randomized controlled trials suggested that NAC, alone or as part of combination therapy, might slow disease progression or improve lung function by reducing oxidative injury to lung tissue.

However, more recent and larger clinical trials have cast doubt on the efficacy of NAC for fibrosis. The PANTHER-IPF trial, a significant multicenter study, found that NAC monotherapy did not significantly improve outcomes in IPF patients compared to placebo. Nonetheless, some subgroup analyses suggest that certain genetic profiles might derive benefit, though this remains an area of active research.

Beyond lung fibrosis, there is limited evidence for NAC’s benefit in other fibrotic conditions (e.g., liver fibrosis), with most data coming from preclinical or animal studies. Overall, while the scientific rationale is plausible and there is some evidence for benefit, especially in earlier or less severe cases, robust clinical evidence in support of NAC as a standard therapy for fibrosis is lacking. Thus, the use is best characterized as having weak scientific support at present.

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