SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2015
Influence of N-acetylcysteine on chronic bronchitis or COPD exacerbations: a meta-analysis.
Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
90 citing papers in PubMed, 8 syntheses or guidelines pooled it, 190 citations in OpenAlex.
- A 7-point evidence-based care discharge protocol for patients hospitalized for exacerbation of COPD: consensus strategy and expert recommendation.NPJ primary care respiratory medicine · 2024Pooled it
- Impact of N-Acetylcysteine on Mucus Hypersecretion in the Airways: A Systematic Review.International journal of chronic obstructive pulmonary disease · 2024Pooled it
- Strength of association between comorbidities and asthma: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Stem Cell-Based Regenerative Therapy and Derived Products in COPD: A Systematic Review and Meta-Analysis.Cells · 2022Pooled it
- Serum bilirubin and chronic obstructive pulmonary disease (COPD): a systematic review.BMC pulmonary medicine · 2021Pooled it
- Romanian clinical guideline for diagnosis and treatment of COPD.The Journal of international medical research · 2020Guideline
- Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2019Pooled it
- The efficacy ofTherapeutic advances in respiratory diseasePooled it
- COPD Patients with a High Exacerbation Risk: Baseline Data Analysis of a National Chinese Prospective Multi-Center Study of Quality Improvement Project.International journal of chronic obstructive pulmonary disease · 2026Trial
- The effect of nebulized N-acetylcysteine on the phlegm of chronic obstructive pulmonary disease: the NEWEST study.BMC pulmonary medicine · 2024Trial
- A double-blind randomized controlled trial of N-acetylcysteine (NAC) for the treatment of acute exacerbation of chronic obstructive pulmonary disease.Respirology case reports · 2024Trial
- N-Acetylcysteine, Tiron, and Their Combination: In Vitro Antioxidant and Anti-Inflammatory Activities and Their Protective Effect in a Rat Model of Acetic Acid-Induced Ulcerative Colitis.International journal of molecular sciences · 2026Article
- N-acetylcysteine: evidence based consensus document on the therapeutic advantages in respiratory diseases (NECTAR).Frontiers in medicine · 2026Review
- Oxidative stress-driven epigenetic reprogramming of immune cells in COPD: from epitranscriptomic and metabolic crosstalk to treatable traits.Frontiers in immunology · 2026Review
- Identification of Th17 Cell-Associated Biomarkers and Their Potential Regulatory Mechanisms in Chronic Obstructive Pulmonary Disease Through Integrated Bioinformatics Analysis and Machine Learning.International journal of chronic obstructive pulmonary disease · 2026Article
- Prevalence and treatment outcomes of latent tuberculosis infection among older patients with chronic obstructive pulmonary disease in an area with intermediate tuberculosis burden.Emerging microbes & infections · 2025Article
- What is the optimal dose of N-acetylcysteine in adult patients with bronchiectasis?-data from the RIBRON registry.Journal of thoracic disease · 2025Article
- Article
- Article
- Protocol for differentiating primary human small airway epithelial cells at the air-liquid interface.American journal of physiology. Lung cellular and molecular physiology · 2025Article
30 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In order to clarify the possible role of N-acetylcysteine (NAC) in the treatment of patients with chronic bronchitis and chronic obstructive pulmonary disease (COPD), we have carried out a meta-analysis testing the available evidence that NAC treatment may be effective in preventing exacerbations of chronic bronchitis or COPD and evaluating whether there is a substantial difference between the responses induced by low (≤ 600 mg per day) and high (> 600 mg per day) doses of NAC. The results of the present meta-analysis (13 studies, 4155 COPD patients, NAC n = 1933; placebo or controls n = 2222) showed that patients treated with NAC had significantly and consistently fewer exacerbations of chronic bronchitis or COPD (relative risk 0.75, 95% CI 0.66-0.84; p < 0.01), although this protective effect was more apparent in patients without evidence of airway obstruction. However, high doses of NAC were also effective in patients suffering from COPD diagnosed using spirometric criteria (relative risk 0.75, 95% CI 0.68-0.82; p = 0.04). NAC was well tolerated and the risk of adverse reactions was not dose-dependent (low doses relative risk 0.93, 95% CI 0.89-0.97; p = 0.40; high doses relative risk 1.11, 95% CI 0.89-1.39; p = 0.58). The strong signal that comes from this meta-analysis leads us to state that if a patient suffering from chronic bronchitis presents a documented airway obstruction, NAC should be administered at a dose of ≥ 1200 mg per day to prevent exacerbations, while if a patient suffers from chronic bronchitis, but is without airway obstruction, a regular treatment of 600 mg per day seems to be sufficient.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.