Evidence map›Paper›PMID 32380989›Full record

SynthesisBMC pulmonary medicine2020

Efficacy, safety, and tolerability of combined pirfenidone and N-acetylcysteine therapy: a systematic review and meta-analysis.

Hanyu Shi, Dawei Yin, Francesco Bonella, Michael Kreuter, Ute Oltmanns, Xuren Li, Shouchun Peng, Luqing Wei

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC pulmonary medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Article
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Hanyu ShiDepartment of Respiratory and Critical Care Medicine, Special Medical Center of Chinese People's Armed Police Forces, Tianjin, China.
Dawei YinDepartment of Respiratory and Critical Care Medicine, Special Medical Center of Chinese People's Armed Police Forces, Tianjin, China.
Francesco BonellaDepartment of Pneumology, Ruhrlandklinik, Centre for Interstitial and Rare Lung Disease, University Hospital, University Duisburg-Essen, Essen, Germany.
Michael KreuterCenter for Interstitial and Rare Lung Diseases, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Ute OltmannsCenter for Interstitial and Rare Lung Diseases, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Xuren LiDepartment of Respiratory and Critical Care Medicine, Special Medical Center of Chinese People's Armed Police Forces, Tianjin, China.
Shouchun PengDepartment of Respiratory and Critical Care Medicine, Special Medical Center of Chinese People's Armed Police Forces, Tianjin, China.
Luqing WeiDepartment of Respiratory and Critical Care Medicine, Special Medical Center of Chinese People's Armed Police Forces, Tianjin, China. luqing-wei@163.com.
Chinese People's Armed Police ForceHeidelberg University · DELogistics University of People's Armed Police Force · CNRuhrlandklinik · DE

Funding

Natural Science Foundation of Tianjin City NO.15JCZDJC3500
6 · The paper itself

Abstract

backgroundWhile antifibrotic drugs significantly decrease lung function decline in idiopathic pulmonary fibrosis (IPF), there is still an unmet need to halt disease progression. Antioxidative therapy with N-acetylcysteine (NAC) is considered a potential additional therapy that can be combined with antifibrotics in some patients in clinical practice. However, data on the efficacy, tolerability, and safety of this combination are scarce. We performed a systematic review and meta-analysis to appraise the safety, tolerability, and efficacy of the combination compared to treatment with pirfenidone alone.

methodsWe systematically reviewed all the published studies with combined pirfenidone (PFD) and NAC (PFD + NAC) treatment in IPF patients. The primary outcomes referred to decline in pulmonary function tests (PFTs) and the rates of IPF patients with side effects.

resultsIn the meta-analysis, 6 studies with 319 total IPF patients were included. The PFD + NAC group was comparable to the PFD alone group in terms of the predicted forced vital capacity (FVC%) and predicted diffusion capacity for carbon monoxide (DLco%) from treatment start to week 24. Side effects and treatment discontinuation rates were also comparable in both groups.

conclusionThis systematic review and meta-analysis suggests that combination with NAC does not alter the efficacy, safety, or tolerability of PFD in comparison to PFD alone in IPF patients.

Indexed as

AcetylcysteineIdiopathic Pulmonary FibrosisPyridonesAdministration, InhalationAnti-Inflammatory Agents, Non-SteroidalCarbon MonoxideDrug Therapy, CombinationFree Radical ScavengersHumansRandomized Controlled Trials as TopicTreatment OutcomeVital CapacityAcetylcysteineAnti-Inflammatory Agents, Non-SteroidalCarbon MonoxideFree Radical ScavengerspirfenidonePyridonesAcetylcysteineIdiopathic pulmonary fibrosisMeta-analysisPirfenidoneSystematic review

Identifiers

PMID32380989
PMCPMC7204217
OpenAlexW3021156786

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.