SynthesisBritish journal of clinical pharmacology2016
N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review.
Synthesis in British journal of clinical pharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- N-Acetylcysteine for Preventing Acetaminophen-Induced Liver Injury: A Comprehensive Review.Frontiers in pharmacology · 2022Pooled it
- N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review.British journal of clinical pharmacology · 2016Pooled it
- Repurposing landscape of N-acetylcysteine: A scoping review of reviews toward clinical translation.PloS one · 2026Article
- Re-exploration of the pharmacotherapeutic strategy for drug-induced liver injury: a narrative review.Frontiers in medicine · 2026Review
- Acute Fatty Liver in Pregnancy: Literature Review.Cureus · 2025Review
- A new opportunity for N-acetylcysteine. An outline of its classic antioxidant effects and its pharmacological potential as an epigenetic modulator in liver diseases treatment.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- Article
- Review
- A novel approach to alleviate acetaminophen-induced hepatotoxicity with hybrid balloon flower root-derived exosome-like nanoparticles (BDEs) with silymarin via inhibition of hepatocyte MAPK pathway and apoptosis.Cell communication and signaling : CCS · 2024Article
- Gasdermin-E-Dependent Non-Canonical Pyroptosis Promotes Drug-Induced Liver Failure by Promoting CPS1 deISGylation and Degradation.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- The Use and Potential Benefits of N-Acetylcysteine in Non-Acetaminophen Acute Liver Failure: An Etiology-Based Review.Biomedicines · 2024Review
- Hepatic pyruvate and alanine metabolism are critical and complementary for maintenance of antioxidant capacity and resistance to oxidative insult.Molecular metabolism · 2023Article
- Article
- The multifaceted role of macrophages during acute liver injury.Frontiers in immunology · 2023Review
- Treatment of Drug-Induced Liver Injury.Biomedicines · 2022Review
- Hepatic ROS Mediated Macrophage Activation Is Responsible for Irinotecan Induced Liver Injury.Cells · 2022Article
- Severe tyrosine-kinase inhibitor induced liver injury in metastatic renal cell carcinoma patients: two case reports assessed for causality using the updated RUCAM and review of the literature.BMC gastroenterology · 2022Review
- Review
- Overview of drug induced liver injury in Brazil: What is the role of public health policy on the evidence?World journal of gastrointestinal pharmacology and therapeutics · 2021Article
- Drug-Induced Liver Injury: Clinical Evidence of N-Acetyl Cysteine Protective Effects.Oxidative medicine and cellular longevity · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsN-acetylcysteine (NAC) may be useful in the management of non-paracetamol drug-induced liver injury (DILI). Our objective was to review systematically evidence for the use of NAC as a therapeutic option for non-paracetamol DILI.
methodsWe searched for randomized controlled trials (RCTs) and prospective cohort studies. We searched several bibliographic databases, grey literature sources, conference proceedings and ongoing trials. Our pre-specified primary outcomes were all cause and DILI related mortality, time to normalization of liver biochemistry and adverse events. Secondary outcomes were proportion receiving liver transplant, time to transplantation, transplant-free survival and hospitalization duration.
resultsWe identified one RCT of NAC vs. placebo in patients with non-paracetamol acute liver failure. There was no difference in the primary outcomes of overall survival at 3 weeks between NAC [70%, 95% confidence interval (CI) = 60%, 81%, n = 81] and placebo (66%, 95% CI = 56%, 77%, n = 92). NAC significantly improved the secondary outcomes of transplant-free survival compared with placebo: 40% NAC (95% CI = 28%, 51%) vs. 27% placebo (95% CI = 18%, 37%). A subgroup analysis according to aetiology found improved transplant-free survival in patients with non-paracetamol DILI, NAC (58%, n = 19) vs. placebo (27%, n = 26), odds ratio (OR) 0.27 (95% CI = 0.076, 0.942). Overall survival was similar, NAC (79%) vs. placebo (65%);, OR 0.50 (95% CI = 0.13, 1.98).
conclusionCurrent available evidence is limited and does not allow for any firm conclusions to be made regarding the role of NAC in non-paracetamol DILI. We therefore highlight the need for further research in this area.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.