Efficacy, safety, and tolerability of combined pirfenidone and N-acetylcysteine therapy: a systematic review and meta-analysis

BMC Pulmonary Medicine

Ute Oltmanns¹  Michael Kreuter¹  Francesco Bonella²  Luqing Wei³  Xuren Li³  Shouchun Peng³  Hanyu Shi³  Dawei Yin³ 

[1] Center for Interstitial and Rare Lung Diseases, Thoraxklinik, University of Heidelberg;Department of Pneumology, Ruhrlandklinik, Centre for Interstitial and Rare Lung Disease, University Hospital, University Duisburg-Essen;Department of Respiratory and Critical Care Medicine, Special Medical Center of Chinese People’s Armed Police Forces;

关键词: Idiopathic pulmonary fibrosis;    Pirfenidone;    Acetylcysteine;    Meta-analysis;    Systematic review;   

DOI  :  10.1186/s12890-020-1121-2

来源: DOAJ

【 摘 要 】

Abstract Background While antifibrotic drugs significantly decrease lung function decline in idiopathic pulmonary fibrosis (IPF), there is still an unmet need to halt disease progression. Antioxidative therapy with N-acetylcysteine (NAC) is considered a potential additional therapy that can be combined with antifibrotics in some patients in clinical practice. However, data on the efficacy, tolerability, and safety of this combination are scarce. We performed a systematic review and meta-analysis to appraise the safety, tolerability, and efficacy of the combination compared to treatment with pirfenidone alone. Methods We systematically reviewed all the published studies with combined pirfenidone (PFD) and NAC (PFD + NAC) treatment in IPF patients. The primary outcomes referred to decline in pulmonary function tests (PFTs) and the rates of IPF patients with side effects. Results In the meta-analysis, 6 studies with 319 total IPF patients were included. The PFD + NAC group was comparable to the PFD alone group in terms of the predicted forced vital capacity (FVC%) and predicted diffusion capacity for carbon monoxide (DLco%) from treatment start to week 24. Side effects and treatment discontinuation rates were also comparable in both groups. Conclusion This systematic review and meta-analysis suggests that combination with NAC does not alter the efficacy, safety, or tolerability of PFD in comparison to PFD alone in IPF patients.

【 授权许可】

Unknown