The evidence of the use of oral N-acetylcysteine in the reduction and the prevention of exacerbations in chronic obstructive pulmonary disease
- International Journal of Family & Community Medicine
Inês Pereira,1 Ana Marta Pinto,2 Ana Catarina Silva,3 Ana Gabriela Oliveira,2 Catarina Lamego2
Introduction: Exacerbations are responsible for the majority of morbidity, mortality and costs associated with chronic obstructive pulmonary disease. However, the evidence that oral mucolytics have an important clinical effect on this pathology is limited. The objective of this evidence-based review was to describe the current state of knowledge regarding the reduction and prevention of exacerbations in chronic obstructive pulmonary disease with the use of oral N-acetylcysteine.
Materials and methods: Research was performed on recommended scientific bases in English, Portuguese and Castilian, without restriction on the date of publication, with the MeSH words “Acetylcystein” and “Pulmonary Disease, Chronic Obstructive”. Inclusion and exclusion criteria have been defined. The evaluation of the levels of evidence and the assignment of the recommendation forces were made through the scale Strength Of Recommendation Taxonomy.
Results: Seven articles were obtained through the methodology used: four systematic reviews and three guidelines. All studies concluded that the use of oral N-acetylcysteine decreases and prevents exacerbations in patients with chronic obstructive pulmonary disease.
Discussion: There are few studies that allow us to clearly recommend the use of oral N-acetylcysteine in patients with chronic obstructive pulmonary disease. Still, according to the existing studies and the usual clinical practice, there seems to be benefit with its use in the decrease and in the prevention of exacerbations in this group of patients.
Conclusions: Further studies are needed to evaluate the efficacy and the safety of oral N-acetylcysteine in the reduction and prevention of exacerbations in chronic obstructive pulmonary disease.
chronic obstructive pulmonary disease, oral n-acetylcysteine, exacerbations, prevention, decrease