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N-Acetylcysteine and disease progression in COPD
  1. K Satkunam
  1. Specialist Registrar, Newham University Hospital, London, UK;

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It is known that oxidative stress plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). In this study the anti-oxidant N-acetylcysteine (NAC) was used to assess whether this drug could reduce the rate of lung function decline, reduce the yearly exacerbation rate, or improve clinical outcomes. 523 patients were randomised to receive either 600 mg NAC daily or placebo over a 3 year period. Forced expiratory volume in 1 second (FEV1) and yearly exacerbation rates were monitored.

No significant differences were found in the rate of FEV1 decline (54 ml/year NAC v 47 ml/year placebo) or number of exacerbations per year (1.25 NAC v 1.29 placebo) between the two groups. Further subgroup analysis did suggest that there may be a benefit on the exacerbation rate in those patients not treated with inhaled steroids.

This study has shown that NAC when given at this dose does not reduce the rate of decline in lung function or reduce exacerbation rate in patients with COPD.

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