Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): A randomised placebo-controlled trial

Decramer, Marc; Mölken, MP Rutten-van; Dekhuijzen, P.N.R.; Troosters, T.; Herwaarden, Cees van; Pellegrino, Raffaele; Schayck, C.P. Ovan; Olivieri, Dario; Donno, Mario Del; Backer, Wilfried De

doi:10.1016/j.rmedu.2005.09.021

Cited by 27 publications

(25 citation statements)

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“…Studies in this analysis were of moderate to high quality. The failure of anti-oxidants to reduce the severity of clinical disease characterised by oxidative stress is not unique to kidney injury [78,79], which maybe a reflection of our poor understanding of the role of reactive oxygen species in health and disease.…”

Section: N-acetylcysteinementioning

confidence: 99%

Pharmacological therapies for the prevention of acute kidney injury following cardiac surgery: a systematic review

et al. 2011

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Post-cardiac surgery acute kidney injury (AKI) is common and is associated with a significant increase in morbidity and mortality. We aimed to systematically review randomised trials that assessed the renoprotective utility of pharmacological agents in patients undergoing cardiac surgery. We searched PubMed, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials comparing renoprotective pharmacological interventions with control in adult patients undergoing cardiac surgery with cardiopulmonary bypass. We extracted data for mortality, need for renal replacement therapy (RRT), incidence of AKI, and creatinine clearance at 24-48 h. About 49 randomised controlled trials involving 4605 patients were included. Pharmacological interventions included dopamine, fenoldopam, calcium channel antagonists, natriuretic peptides, diuretics, and N-acetylcysteine. Most trials were of poor quality, with small sample sizes, under-reporting of randomisation procedure, allocation concealment and method of blinding. No pharmacological intervention significantly reduced mortality. Fenoldopam and Atrial Natriuretic Peptide (ANP) reduced the need for renal replacement therapy by 5% (NNT 20, 95% CI 11.3, 83.0) and 3.5% (NNT 29, 95% CI 17.1, 84.4), respectively. Brain Natriuretic Peptide resulted in a 10% reduction in the incidence of AKI (NNT 11, 95% CI 6.2, 32.0). Dopamine caused a significant reduction in creatinine clearance (-4.26 ml/min, 95% CI -7.14, -1.39). The quality of studies that have assessed pharmacological renoprotective agents in cardiac surgery is generally poor. Fenoldopam, ANP and BNP show evidence of renoprotection. Randomised studies evaluating the effect of novel renoprotective agents that are powered to detect clinically relevant differences in outcomes are required.

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Section: N-acetylcysteinementioning

confidence: 99%

Pharmacological therapies for the prevention of acute kidney injury following cardiac surgery: a systematic review

et al. 2011

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“…To date, antioxidant therapies, such as N -acetylcysteine ( NAC ), have failed to improve lung function or quality of life [68] . It is apparent that approaches reliant on stoichiometric scavenging of oxidants are not effective therapeutic strategies.…”

Section: Molecular Determinants Of Oxidative Stress In Copdmentioning

confidence: 99%

Smoking and COPD and Other Respiratory Diseases

Sussan¹,

Biswal²

2011

Cigarette Smoke Toxicity

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“…Eine aktuell veröffentlichte randomisierte, plazebokontrollierte, multizentrische Studie mit NAC 600 mg täglich über 3 Jahre konnte bei COPD-Patienten, die bei Studieneinschluss das Kriterium von mindestens zwei Exazerbationen pro Jahr erfüllen mussten, keinen Effekt auf die Rate der Exazerbationen und die jährliche Abnahme der FEV 1 nachweisen [131]. Eine Subgruppenanalyse zeigte aber, dass die Patienten ohne gleichzeitige ICS-Behandlung unter NAC weniger Exazerbationen auswiesen [131].…”

Section: N-acetylcystein Als Antioxidansunclassified

“…Eine Subgruppenanalyse zeigte aber, dass die Patienten ohne gleichzeitige ICS-Behandlung unter NAC weniger Exazerbationen auswiesen [131]. Die insgesamt negativen Daten können möglicherweise mit der zu niedrigen Dosis von 600 mg NAC/d erklärt werden.…”

Section: N-acetylcystein Als Antioxidansunclassified

COPD—pharmakologische Basisbehandlung und Zukunft der antiinflammatorischen Therapie

et al. 2006

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Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. It is caused by chronic inflammation of the airways and the lung parenchyma. Symptomatic treatment is based on bronchodilatation, which leads to a reduction of hyperinflation and relief of dyspnea. Smoking cessation is the only known causative treatment option. Inhaled corticosteroids (ICS) reduce exacerbations and, potentially, mortality. Future therapies should ameliorate chronic inflammation and thus stop the annual decline of lung function. In face of increasing mortality and morbidity more research is needed.

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Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): A randomised placebo-controlled trial

Cited by 27 publications

References 0 publications

Pharmacological therapies for the prevention of acute kidney injury following cardiac surgery: a systematic review

Pharmacological therapies for the prevention of acute kidney injury following cardiac surgery: a systematic review

Smoking and COPD and Other Respiratory Diseases

COPD—pharmakologische Basisbehandlung und Zukunft der antiinflammatorischen Therapie

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