Efficacy of N-Acetylcysteine as an Adjuvant Therapy for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

被引:0
作者
He, Tingting [1 ]
Ren, Kehui [1 ]
Xiang, Li [1 ]
Yao, Huan [2 ]
Huang, Yucheng [1 ]
Gao, Yongxiang [1 ]
机构
[1] Chengdu Univ Tradit Chinese Med, Sch Clin Med, Chengdu, Sichuan, Peoples R China
[2] Sichuan Prov Engn Res Ctr Innovat Redev Famous Cla, Pengzhou, Sichuan, Peoples R China
基金
中国国家自然科学基金;
关键词
N-acetylcysteine; rheumatoid arthritis; oxidative stress; inflammation; meta-analysis;
D O I
10.12968/hmed.2024.0560
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims/Background Rheumatoid arthritis (RA) is an inflammatory autoimmune disease and N-acetylcysteine (NAC) is considered a potential therapeutic agent for RA due to strong antioxidant and antiinflammatory properties. Therefore, this systematic review and meta-analysis aimed to evaluate the efficacy of NAC as an adjuvant therapy for RA. Methods A systematic search was conducted across five databases from inception to 1 August 2024, including CINAHL, Cochrane Library, EMBASE, PubMed, and Web of Science. The Cochrane riskof-bias tool for randomized trials was used to assess the quality of the included studies. Sensitivity analysis was performed when significant heterogeneity was identified. Results Four studies involving 204 patients were included in our meta-analysis. The results indicated that NAC alleviated disease activity in RA patients (Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR): mean difference (MD) = 0.54). Additionally, NAC reduced inflammatory markers (erythrocyte sedimentation rate (ESR): MD = 3.00). However, the beneficial effects of NAC on oxidative stress in RA patients were not observed. Conclusion This meta-analysis demonstrated the efficacy of NAC in reducing inflammatory markers, improving joint tenderness, and swelling in patients with RA.
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页数:16
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共 39 条
[1]  
Abbasifard M., Khorramdelazad H., Rostamian A., Rezaian M., Askari P.S., Sharifi G.T.K., Et al., Effects of N-acetylcysteine on systemic lupus erythematosus disease activity and its associated complications: A randomized double-blind clinical trial study, Trials, 24, (2023)
[2]  
Aletaha D., Neogi T., Silman A.J., Funovits J., Felson D.T., Bingham C.O., Et al., 2010 rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative, Annals of the Rheumatic Diseases, 69, pp. 1580-1588, (2010)
[3]  
Batooei M., Tahamoli-Roudsari A., Basiri Z., Yasrebifar F., Shahdoust M., Eshraghi A., Et al., Evaluating the Effect of Oral N-acetylcysteine as an Adjuvant Treatment on Clinical Outcomes of Patients with Rheumatoid Arthritis: A Randomized, Double Blind Clinical Trial, Reviews on Recent Clinical Trials, 13, pp. 132-138, (2018)
[4]  
Blagov A.V., Orekhova V.A., Sukhorukov V.N., Melnichenko A.A., Orekhov A.N., Potential Use of Antioxidant Compounds for the Treatment of Inflammatory Bowel Disease, Pharmaceuticals, 16, (2023)
[5]  
Clark R.S.B., Empey P.E., Kochanek P.M., Bell M.J., N-Acetylcysteine and Probenecid Adjuvant Therapy for Traumatic Brain Injury, Neurotherapeutics, 20, pp. 1529-1537, (2023)
[6]  
Cui Y., Zhu Q., Hao H., Flaker G.C., Liu Z., N-Acetylcysteine and Atherosclerosis: Promises and Challenges, Antioxidants, 12, (2023)
[7]  
Da Fonseca L.J.S., Nunes-Souza V., Goulart M.O.F., Rabelo L.A., Oxidative Stress in Rheumatoid Arthritis: What the Future Might Hold regarding Novel Biomarkers and Add-On Therapies, Oxidative Medicine and Cellular Longevity, 2019, (2019)
[8]  
Di Matteo A., Bathon J.M., Emery P., Rheumatoid arthritis, Lancet, 402, pp. 2019-2033, (2023)
[9]  
Djordjevic K., Milojevic Samanovic A., Veselinovic M., Zivkovic V., Mikhaylovsky V., Mikerova M., Et al., Oxidative Stress Mediated Therapy in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis, Antioxidants, 12, (2023)
[10]  
Eghtedari Y., Oh L.J., Girolamo N.D., Watson S.L., The role of topical N-acetylcysteine in ocular therapeutics, Survey of Ophthalmology, 67, pp. 608-622, (2022)