Title: Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial
Authors: Decramer, Marc ×
Rutten-van Mölken, Maureen
Dekhuijzen, P N Richard
Troosters, Thierry
van Herwaarden, Cees
Pellegrino, Riccardo
van Schayck, C P Onno
Olivieri, Dario
Del Donno, Mario
De Backer, Wilfried
Lankhorst, Ida
Ardia, Alfredo #
Issue Date: May-2005
Series Title: Lancet vol:365 issue:9470 pages:1552-60
Abstract: BACKGROUND: Increased oxidative stress is important in the pathogenesis of chronic obstructive pulmonary disease (COPD). We postulated that treatment with the antioxidant N-acetylcysteine would reduce the rate of lung-function decline, reduce yearly exacerbation rate, and improve outcomes. METHODS: In a randomised placebo-controlled study in 50 centres, 523 patients with COPD were randomly assigned to 600 mg daily N-acetylcysteine or placebo. Patients were followed for 3 years. Primary outcomes were yearly reduction in forced expiratory volume in 1 s (FEV1) and the number of exacerbations per year. Analysis was by intention to treat. FINDINGS: The yearly rate of decline in FEV1 did not differ between patients assigned N-acetylcysteine and those assigned placebo (54 mL [SE 6] vs 47 mL [6]; difference in slope between groups 8 mL [9]; 95% CI -25 to 10). The number of exacerbations per year did not differ between groups (1.25 [SD 1.35] vs 1.29 [SD 1.46]; hazard ratio 0.99 [95% CI 0.89-1.10, p=0.85]). Subgroup analysis suggested that the exacerbation rate might be reduced with N acetylcysteine in patients not treated with inhaled corticosteroids and secondary analysis was suggestive of an effect on hyperinflation. INTERPRETATION: N-acetylcysteine is ineffective at prevention of deterioration in lung function and prevention of exacerbations in patients with COPD.
ISSN: 0140-6736
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Pneumology
Research Group for Cardiovascular and Respiratory Rehabilitation
× corresponding author
# (joint) last author

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