Efficacy and safety of inhaled N-acetylcysteine in idiopathic pulmonary fibrosis: A prospective, single-arm study

Respiratory Investigation

Volumn 54, Issue 3, 2016, Pages 156-161

  Okuda, Ryo ^a   Matsushima, Hidekazu ^a   Oba, Tomohiro ^a   Kawabe, Rie ^a   Matsubayashi, Minako ^a   Amano, Masako ^a   Nishizawa, Tomotaka ^a   Honda, Koujiro ^a  

^a SAITAMA RED CROSS HOSPITAL   (Japan)

Author keywords

Forced vital capacity; Idiopathic pulmonary fibrosis; Inhalation; Krebs von den Lungen 6; N acetylcysteine

Indexed keywords

ACETYLCYSTEINE; BIOLOGICAL MARKER; KREBS VON DEN LUNGEN 6; SURFACTANT PROTEIN D; UNCLASSIFIED DRUG;

6 MIN WALK TEST; ADULT; AGED; ARTICLE; CHRONIC RESPIRATORY FAILURE; CLINICAL ARTICLE; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; COUGHING; DISEASE CLASSIFICATION; DISEASE COURSE; DISEASE SEVERITY; DRUG EFFICACY; DRUG INDICATION; DRUG SAFETY; DRUG TOLERABILITY; FEMALE; FIBROSING ALVEOLITIS; FORCED VITAL CAPACITY; HUMAN; HUMAN TISSUE; MALE; NEBULIZER; OXYGEN SATURATION; PNEUMOMEDIASTINUM; PNEUMONIA; PROSPECTIVE STUDY; PROVOCATION TEST; PULSE OXIMERTY; RESPIRATORY TRACT PARAMETERS; TREATMENT DURATION; TREATMENT OUTCOME; CLINICAL TRIAL; IDIOPATHIC PULMONARY FIBROSIS; INHALATIONAL DRUG ADMINISTRATION; LUNG FUNCTION TEST; PATHOPHYSIOLOGY; SEVERITY OF ILLNESS INDEX; TIME FACTOR; VITAL CAPACITY;

ACETYLCYSTEINE; ADMINISTRATION, INHALATION; AGED; FEMALE; HUMANS; IDIOPATHIC PULMONARY FIBROSIS; MALE; RESPIRATORY FUNCTION TESTS; SEVERITY OF ILLNESS INDEX; TIME FACTORS; TREATMENT OUTCOME; VITAL CAPACITY;

EID: 84950277687     PISSN: 22125345     EISSN: 22125353     Source Type: Journal    
DOI: 10.1016/j.resinv.2015.10.001     Document Type: Article

References (25)

1. Raghu G., Collard H.R., Egan J.J., et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011, 183:788-824.
2. Borok Z., Buhl R., Grimes G.J., et al. Effect of glutathione aerosol on oxidant-antioxidant imbalance in idiopathic pulmonary fibrosis. Lancet 1991, 338:215-216.
3. Gillissen A., Nowak D. Characterization of N-acetylcysteine and ambroxol in anti-oxidant therapy. Respir Med 1998, 92:609-623.
4. Beeh K.M., Beier J., Haas I.C., et al. Glutathione deficiency of the lower respiratory tract in patients with idiopathic pulmonary fibrosis. Eur Respir J 2002, 19:1119-1123.
5. Cantin A., Hubbard R.C., Crystal R.G. Glutathione deficiency in the epithelial lining fluid of the lower respiratory tract of patients with idiopathic pulmonary fibrosis. Am Rev Respir Dis 1989, 139:370-372.
6. Zappala C.J., Latsi P.I., Nicholson A.G., et al. Marginal decline in forced vital capacity is associated with a poor outcome in idiopathic pulmonary fibrosis. Eur Respir J 2010, 35:830-836.
7. Demedts M., Behr J., Buhl R., et al. High-dose acetylcysteine in idiopathic pulmonary fibrosis. N Engl J Med 2005, 353:2229-2242.
8. The Idiopathic Pulmonary Fibrosis Clinical Research Network Randomized trial of acetylcysteine in idiopathic pulmonary fibrosis. N Engl J Med 2014, 370:2093-2101.
9. Taniguchi H, Kondoh K. Revised criteria for acute exacerbation of idiopathic pulmonary fibrosis. The Annual Report by Study Group of Ministry of Health and Welfare for Diffuse Lung Diseases Research Group from the Ministry of Health, Labor and Welfare of Japanese Government; 2004. p. 114-9.
10. National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) v4.0; 2015 . http://www.ctep.cancer.gov.09/03/2015.
11. Ley B., Ryerson C.J., Vittinghoff E., et al. A multidimensional index and staging system for idiopathic pulmonary fibrosis. Ann Intern Med 2012, 156:684-691.
12. Okuda R., Wada S., Ohba T., et al. A case of pneumonitis induced by the inhalation of N-acetylcysteine. Nihon Kokyuki Gakkai Zasshi 2014, 3:300-303. [in Japanese, abstract in English].
13. Tomioka H., Kuwata Y., Inaka K., et al. A pilot study of aerosolized N-acetylcysteine for idiopathic pulmonary fibrosis. Respirology 2005, 10:449-455.
14. Homma S., Azuma A., Taniguchi H., et al. Efficacy of inhaled N-acetylcysteine monotherapy in patients with early stage idiopathic pulmonary fibrosis. Respirology 2012, 17:467-477.
15. Sakamoto S., Muramatsu Y., Satoh K., et al. Effectiveness of combined therapy with pirfenidone and inhaled N-acetylcysteine for advanced idiopathic pulmonary fibrosis: a case-control study. Respirology 2015, 20:445-452.
16. Okuda R., Hagiwara R., Baba T., et al. Safety and efficacy of pirfenidone in idiopathic pulmonary fibrosis in clinical practice. Respir Med 2013, 107:1431-1437.
17. Sakamoto S., Itoh T., Muramatsu Y., et al. Efficacy of pirfenidone in patients with advanced-stage idiopathic pulmonary fibrosis. Intern Med 2013, 52:2495-2501.
18. Rodenstein D., DeCoster A., Gazzaniga A. Pharmacokinetics of oral acetylcysteine absorption, binding and metabolism in patients with respiratory disorders. Clin Pharmacokinet 1978, 3:247-254.
19. Cotgreave I., Eklund A., Larsson A., et al. No penetration of orally administered N-acetylcysteine into bronchoalveolar lavage fluid. Eur J Respir Dis 1987, 70:73-77.
20. Bridgeman M.M.E., Marsden M., Selby C., et al. Effect of N-acetyl cysteine on the concentrations of thiols in plasma, bronchoalveolar lavage fluid, and lung tissue. Thorax 1994, 49:670-675.
21. Hagiwara S., Ishii Y., Kitamura S. Aerosolized administration of N-acetylcysteine attenuates lung fibrosis induced by bleomycin in mice. Am J Respir Crit Care Med 2000, 162:225-231.
22. Richeldi L., du Bois R.M., Raghu G., et al. Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med 2014, 370:2071-2082.
23. Lama V.N., Flaherty K.R., Toews G.B., et al. Prognostic value of desaturation during a 6-minute walk test in idiopathic interstitial pneumonia. Am J Respir Crit Care Med 2003, 168:1084-1090.
24. Yokoyama A., Kohno N., Hamada H., et al. Circulating KL-6 predicts the outcome of rapidly progressive idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 1998, 158:1680-1684.
25. Bando M., Hosono T., Mato N., et al. Long-term efficacy of inhaled N-acetylcysteine in patients with idiopathic pulmonary fibrosis. Intern Med 2010, 49:2289-2296.