COPD & Emphysema Support Group
COPD is a progressive disease characterized by airflow obstruction or limitation. Emphysema is characterized by loss of elasticity of the lung tissue, destruction of structures supporting the alveoli and of capillaries feeding the alveoli. Both have symptoms that include shortness of breath, among other respiratory troubles. If you are a COPD or Emphysema sufferer, join...
If your not taking it, maybe you should think about it...
N-acetylcysteine for COPD: another trial shows benefit (PANTHEON)
Can N-acetylcysteine help prevent exacerbations of chronic obstructive pulmonary disease (COPD)? Another randomized trial says yes.
N-acetylcysteine, or NAC, is a nutritional supplement with antioxidant and anti-inflammatory properties. After ingestion, N-acetylcysteine is metabolized into glutathione, a key antioxidant with effects throughout the body. In the lungs, glutathione deficiency (common in alcoholics) is linked to a higher risk for ARDS. People with COPD and smokers without COPD tend to have lower glutathione levels, which correlate with worse lung function.
Oral N-acetylcysteine is safe and has a good physiologic rationale as a supportive treatment for COPD. Does it work?
The largest trial to date (BRONCUS, n=523 in 2005) did not show any benefit of 600 mg N-acetylcysteine daily for COPD, but some argued that dose was too low.
In a randomized trial (n=120) published in Chest in 2013, 600 mg N-acetylcysteine twice daily prevented exacerbations in mild to moderate COPD.
In a meta-analysis of 11 randomized trials published in COPD in 2013, high-dose NAC (600 mg bid or more) reduced the severity and frequency of COPD exacerbations.
Meta-analyses by Cochrane in 2010 and by Grandjean et al in 2000 also suggested NAC might reduce COPD exacerbations.
In the latest news, Zheng et al reported the results of their PANTHEON trial in Lancet Respiratory Medicine in January 2014. They randomized 1006 Chinese patients at 34 centers with moderate-to-severe COPD to receive either N-acetylcysteine 600 mg b.i.d. or placebo for one year. Those treated with NAC had significantly fewer exacerbations (~1.5 vs. ~1.2 per year), with a number needed to treat of 3 to prevent one exacerbation in a year.
If real, thats a huge benefit: Advair had a number needed to treat of about 4 to prevent a COPD exacerbation in randomized trials including TORCH. Given the equivocal results in the past, it seems appropriate to be optimistic but skeptical of this magnitude of benefit. A large multicenter randomized trial in North America and Europe would seem like a moral imperative, given the suggestion of benefit, the magnitude of the problem of COPD, and the ready availability of a nontoxic and inexpensive potential therapy. Are our fearless leaders performing or planning one? Not yet, as listed on clinicaltrials.gov (where there are just a few mom-and-pops described at single centers, n = 40-60).
You can always direct your COPD patients to the local or online supplement store, where NAC costs about $9 for a months supply. But supplements arent regulated by the FDA, and theres no way to guarantee the actual dose. Dont prescribe the liquid form of NAC (Mucomyst) it smells and tastes terrible, like rotten eggs.
Zheng et al. Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial. The Lancet Respiratory Medicine, Volume 2, Issue 3, Pages 187 194, March 2014.
http://pulmccm.org/main/2014/randomized-controlled-trials/n-acetylcysteine-copd-another-trial-shows-benefit/?art=&utm_source=Email+Updates+from+PulmCCM&utm_campaign=cf76306759-USP_mar_24_2014&utm_medium=email&utm_term=0_e9d9e09c7c-cf76306759-312007369
I know most of you already know about NAC N-Acetyl-Cdysteine, but for those who don't might find this very helpful.
My Pulmonary doctor is promoting because of the positive results in the studies, it really does work for cutting down on mucus and exerbations.
I hope our all well and breathing easy,
always
Love Holly
N-acetylcysteine for COPD: another trial shows benefit (PANTHEON)
Can N-acetylcysteine help prevent exacerbations of chronic obstructive pulmonary disease (COPD)? Another randomized trial says yes.
N-acetylcysteine, or NAC, is a nutritional supplement with antioxidant and anti-inflammatory properties. After ingestion, N-acetylcysteine is metabolized into glutathione, a key antioxidant with effects throughout the body. In the lungs, glutathione deficiency (common in alcoholics) is linked to a higher risk for ARDS. People with COPD and smokers without COPD tend to have lower glutathione levels, which correlate with worse lung function.
Oral N-acetylcysteine is safe and has a good physiologic rationale as a supportive treatment for COPD. Does it work?
The largest trial to date (BRONCUS, n=523 in 2005) did not show any benefit of 600 mg N-acetylcysteine daily for COPD, but some argued that dose was too low.
In a randomized trial (n=120) published in Chest in 2013, 600 mg N-acetylcysteine twice daily prevented exacerbations in mild to moderate COPD.
In a meta-analysis of 11 randomized trials published in COPD in 2013, high-dose NAC (600 mg bid or more) reduced the severity and frequency of COPD exacerbations.
Meta-analyses by Cochrane in 2010 and by Grandjean et al in 2000 also suggested NAC might reduce COPD exacerbations.
In the latest news, Zheng et al reported the results of their PANTHEON trial in Lancet Respiratory Medicine in January 2014. They randomized 1006 Chinese patients at 34 centers with moderate-to-severe COPD to receive either N-acetylcysteine 600 mg b.i.d. or placebo for one year. Those treated with NAC had significantly fewer exacerbations (~1.5 vs. ~1.2 per year), with a number needed to treat of 3 to prevent one exacerbation in a year.
If real, thats a huge benefit: Advair had a number needed to treat of about 4 to prevent a COPD exacerbation in randomized trials including TORCH. Given the equivocal results in the past, it seems appropriate to be optimistic but skeptical of this magnitude of benefit. A large multicenter randomized trial in North America and Europe would seem like a moral imperative, given the suggestion of benefit, the magnitude of the problem of COPD, and the ready availability of a nontoxic and inexpensive potential therapy. Are our fearless leaders performing or planning one? Not yet, as listed on clinicaltrials.gov (where there are just a few mom-and-pops described at single centers, n = 40-60).
You can always direct your COPD patients to the local or online supplement store, where NAC costs about $9 for a months supply. But supplements arent regulated by the FDA, and theres no way to guarantee the actual dose. Dont prescribe the liquid form of NAC (Mucomyst) it smells and tastes terrible, like rotten eggs.
Zheng et al. Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial. The Lancet Respiratory Medicine, Volume 2, Issue 3, Pages 187 194, March 2014.
http://pulmccm.org/main/2014/randomized-controlled-trials/n-acetylcysteine-copd-another-trial-shows-benefit/?art=&utm_source=Email+Updates+from+PulmCCM&utm_campaign=cf76306759-USP_mar_24_2014&utm_medium=email&utm_term=0_e9d9e09c7c-cf76306759-312007369
I know most of you already know about NAC N-Acetyl-Cdysteine, but for those who don't might find this very helpful.
My Pulmonary doctor is promoting because of the positive results in the studies, it really does work for cutting down on mucus and exerbations.
I hope our all well and breathing easy,
always
Love Holly
I'm still at moderate stage and always wish to know of things that are effective in treating this nuisance. I had no side effects with the NAC either.
It should be pointed out that a byproduct of NAC causes kidney stones. That's why it is important to take Vitamin C with NAC. The typical recommendation is 600 mg NAC with 1000 mg Vitamin C twice a day.
Since I already keep infections at bay with the silver water maybe I didn't need whatever it offers. As has been repeated here so often what works for some won't work for all. Just always be careful with dosage of any supplements. Remember just cause you saw it on the web doesn't make it the perfect cure for everyone or the MDs would reccomend it and be getting kickbacks from pharm. companies.
Cindy and Susan....does it help a lot with the mucus? Do either of you suffer any stomach upset from taking it?
No stomach upsets with the NAC. I take Vitamin C as well but not as much as bold print recommended.
Acetylcysteine is a mucolytic (medicine that destroys or dissolves mucus). It is usually given by inhalation but may be given in other ways in a hospital.
Acetylcysteine is used for certain lung conditions when increased amounts of mucus make breathing difficult. Acetylcysteine liquefies (thins) or dissolves mucus so that it may be coughed up. Sometimes the mucus may have to be removed by suction.
This medicine is available only with your doctor's prescription.
This product is available in the following dosage forms:
http://www.mayoclinic.org/drugs-supplements/acetylcysteine-inhalation-route/description/drg-20061456