For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
2
views
18
references
 Top references
cited by
15
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      616
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Effect of N-acetylcysteine on exacerbations of bronchiectasis (BENE): a randomized controlled trial

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          N-acetylcysteine is a classic mucolytic agent. This study aimed to investigate the efficacy of N-acetylcysteine on reducing the risk of exacerbations in bronchiectasis patients.

          Methods

          A prospective, randomized, controlled trial was conducted between April 1, 2014 and December 31, 2016 in five general hospitals in Shandong Province, China. Adult bronchiectasis patients with at least two exacerbations in the past year were potentially eligible. Patients were randomly assigned to receive oral N-acetylcysteine (600 mg, twice daily, 12 months) or on-demand treatment.

          Results

          A total of 161 patients were eligible for randomization (81 to the N-acetylcysteine group and 80 to the control group). During the 12-month follow-up, the incidence of exacerbations in the N-acetylcysteine group was significantly lower than that in the control group (1.31 vs. 1.98 exacerbations per patient-year; risk ratio, 0.41; 95% CI, 0.17–0.66; P = 0.0011). The median number of exacerbations in the N-acetylcysteine group was 1 (0.5–2), compared with 2 (1–2) in the control group (U = − 2.95, P = 0.003). A total of 24.7% of the N-acetylcysteine group patients and 11.3% of the control group patients remained exacerbation-free throughout the 12-month follow-up ( χ 2  = 4.924, P = 0.026). Compared with the control group, the volume of 24-h sputum in the N-acetylcysteine group was significantly reduced ( t = − 3.091, P = 0.002). Additionally, the N-acetylcysteine group showed a significant improvement in the quality of life. No severe adverse events were reported in the intervention group.

          Conclusion

          The long-term use of N-acetylcysteine is able to reduce the risk of exacerbations for bronchiectasis patients in Shandong Province, China. The results of this study should be verified in a larger randomized controlled trial.

          Trial registration

          ClinicalTrials.gov (NCT02088216) (Registered date: March 5, 2014).

          Related collections

          Most cited references18

          • Record: found
          • Abstract: found
          • Article: not found

          Advances in bronchiectasis: endotyping, genetics, microbiome, and disease heterogeneity

          Patrick A Flume, James Chalmers, Kenneth Olivier (2018)
          Bronchiectasis is a condition characterized by pathological dilation of the airways. More specifically, the radiographic demonstration of airways enlargement is the common feature of a heterogeneous set of conditions and clinical presentations. There are no approved therapies for the condition other than for bronchiectasis caused by cystic fibrosis. The heterogeneity of bronchiectasis is the major challenge in clinical practice and the major reason for difficulty in achieving endpoints in clinical trials. Recent observations have improved our knowledge regarding bronchiectasis such that it may be more effective to describe patients according to a heterogeneous group of endotypes, defined by a distinct functional or pathobiological mechanism, or clinical phenotypes, defined by relevant and common features of disease. In doing so, we may finally develop more specific therapies needed to effectively treat our patients. Here we describe some of the recent advances in endotyping, genetics and disease heterogeneity of bronchiectasis including observations related to the microbiome.
          Article 0 comments Cited 141 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The COPD assessment test: a systematic review.

            Nisha Gupta, Lancelot M. Pinto, Andreea Morogan … (2014)
            The COPD assessment test (CAT) is a self-administered questionnaire that measures health-related quality of life. We aimed to systematically evaluate the literature for reliability, validity, responsiveness and minimum clinically important difference (MCID) of the CAT. Multiple databases were searched for studies analysing the psychometric properties of the CAT in adults with chronic obstructive pulmonary disease. Two reviewers independently screened, selected and extracted data, and assessed methodological quality of relevant studies using the COSMIN checklist. From 792 records identified, 36 studies were included. The number of participants ranged from 45 to 6469, mean age from 56 to 73 years, and mean forced expiratory volume in 1 s from 39% to 98% predicted. Internal consistency (reliability) was 0.85-0.98, and test-retest reliability was 0.80-0.96. Convergent and longitudinal validity using Pearson's correlation coefficient were: SGRQ-C 0.69-0.82 and 0.63, CCQ 0.68-0.78 and 0.60, and mMRC 0.29-0.61 and 0.20, respectively. Scores differed with GOLD stages, exacerbation and mMRC grades. Mean scores decreased with pulmonary rehabilitation (2.2-3 units) and increased at exacerbation onset (4.7 units). Only one study with adequate methodology reported an MCID of 2 units and 3.3-3.8 units using the anchor-based approach and distribution-based approach, respectively. Most studies had fair methodological quality. We conclude that the studies support the reliability and validity of the CAT and that the tool is responsive to interventions, although the MCID remains debatable.
            Article 0 comments Cited 98 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study.

              Jacky Loo, Jonathan Chan, Luca Raiteri … (2013)
              The mucolytic and antioxidant effects of N-acetylcysteine (NAC) may have great value in COPD treatment. However, beneficial effects have not been confirmed in clinical studies, possibly due to insufficient NAC doses and/or inadequate outcome parameters used. The objective of this study was to investigate high-dose NAC plus usual therapy in Chinese patients with stable COPD. The 1-year HIACE (The Effect of High Dose N-acetylcysteine on Air Trapping and Airway Resistance of Chronic Obstructive Pulmonary Disease-a Double-blinded, Randomized, Placebo-controlled Trial) double-blind trial conducted in Kwong Wah Hospital, Hong Kong, randomized eligible patients aged 50 to 80 years with stable COPD to NAC 600 mg bid or placebo after 4-week run-in. Lung function parameters, symptoms, modified Medical Research Council (mMRC) dyspnea and St. George's Respiratory Questionnaire (SGRQ) scores, 6-min walking distance (6MWD), and exacerbation and admission rates were measured at baseline and every 16 weeks for 1 year. Of 133 patients screened, 120 were eligible (93.2% men; mean age, 70.8±0.74 years; %FEV1 53.9±2.0%). Baseline characteristics were similar in the two groups. At 1 year, there was a significant improvement in forced expiratory flow 25% to 75% (P=.037) and forced oscillation technique, a significant reduction in exacerbation frequency (0.96 times/y vs 1.71 times/y, P=.019), and a tendency toward reduction in admission rate (0.5 times/y vs 0.8 times/y, P=.196) with NAC vs placebo. There were no significant between-group differences in mMRC dypsnea score, SGRQ score, and 6MWD. No major adverse effects were reported. In this study, 1-year treatment with high-dose NAC resulted in significantly improved small airways function and decreased exacerbation frequency in patients with stable COPD. ClinicalTrials.gov; No.: NCT01136239; URL: www.clinicaltrials.gov.
              Article 0 comments Cited 69 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Yu Li: qlliyu@163.com
                Journal
                Journal ID (nlm-ta): Respir Res
                Journal ID (iso-abbrev): Respir. Res
                Title: Respiratory Research
                Publisher: BioMed Central (London )
                ISSN (Print): 1465-9921
                ISSN (Electronic): 1465-993X
                Publication date (Electronic): 11 April 2019
                Publication date PMC-release: 11 April 2019
                Publication date (Print): 2019
                Volume: 20
                Electronic Location Identifier: 73
                Affiliations
                [1 ]GRID grid.452402.5, Department of Respiratory Medicine, , Qilu Hospital of Shandong University, ; No. 107 Wenhua Xilu, Jinan, 250012 Shandong Province China
                [2 ]Department of Respiratory Medicine, Jinan City People’s Hospital, Jinan, China
                [3 ]GRID grid.460689.5, Department of Respiratory Medicine, , The Fifth Affiliated Hospital of Xinjiang Medical University, ; Xinjiang, China
                [4 ]Department of Respiratory Medicine, Jining No.1 People’s Hospital, Jining, China
                [5 ]GRID grid.460082.8, Department of Respiratory Medicine, , The Fourth People’s Hospital of Jinan, ; Jinan, China
                [6 ]GRID grid.452704.0, The Second Hospital of Shandong University, ; Jinan, China
                [7 ]GRID grid.476866.d, Department of Respiratory Medicine, , Binzhou People’s Hospital, ; Binzhou, China
                Article
                Publisher ID: 1042
                DOI: 10.1186/s12931-019-1042-x
                PMC ID: 6458826
                PubMed ID: 30975143
                SO-VID: 9eb73e98-78b8-4403-905e-d14067725650
                Copyright © © The Author(s). 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 2 November 2018
                Date accepted : 2 April 2019
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Respiratory medicine
                Keywords: n-acetylcysteine,bronchiectasis,long-term therapy,exacerbations
                Data availability:
                ScienceOpen disciplines: Respiratory medicine
                Keywords: n-acetylcysteine, bronchiectasis, long-term therapy, exacerbations

                Comments

                Comment on this article

                scite_

                Similar content616

                See all similar

                Cited by15

                See all cited by

                Most referenced authors397

                See all reference authors