ArticleBMC musculoskeletal disorders2020
Increased risk of knee osteoarthritis in patients using oral N-acetylcysteine: a nationwide cohort study.
Article in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 13 citations in OpenAlex.
- Mediating role of plasma metabolites in the association between plasma proteins and knee osteoarthritis: An observational study.Medicine · 2026Observational
- A Pre-Clinical Model of Synovitis Using Ex vivo Human Synovial Tissue with Preserved Function and Architecture.Journal of visualized experiments : JoVE · 2026Article
- Article
- Intra-Articular N-Acetylcysteine Reduces Synovitis Without Preventing Cartilage Degeneration in Experimental Osteoarthritis.Biomedicines · 2025Article
- Mechanobiochemical finite element model to analyze impact-loading-induced cell damage, subsequent proteoglycan loss, and anti-oxidative treatment effects in articular cartilage.Biomechanics and modeling in mechanobiology · 2025Article
- Emerging concepts and challenges in the development of disease-modifying osteoarthritis drugs - a more refined perspective.Archives of pharmacal research · 2025Review
- The Mechanism and Inflammatory Markers Involved in the Potential Use of N-acetylcysteine in Chronic Pain Management.Life (Basel, Switzerland) · 2024Review
- Exploring the association between knee osteoarthritis outpatient visits and Asian dust storms: a time-series analysis.Scientific reports · 2024Article
- Mechanistic target of rapamycin (mTOR): a potential new therapeutic target for rheumatoid arthritis.Arthritis research & therapy · 2023Review
- N-Acetyl-L-cysteine in human rheumatoid arthritis and its effects on nitric oxide (NO) and malondialdehyde (MDA): analytical and clinical considerations.Amino acids · 2022Review
- A Deep Learning Model to Predict Knee Osteoarthritis Based on Nonimage Longitudinal Medical Record.Journal of multidisciplinary healthcare · 2021Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKnee osteoarthritis (OA) is known to be a progressive degenerative disorder; however, recent evidence suggests that inflammatory mediators contribute to cartilage degradation. Studies have reported that N-acetylcysteine (NAC) had a promising effect on the reduction of the synthesis of proinflammatory and structural mediators by synovial cells. Given the lack of relevant clinical trials, we conducted this study to determine the relationship between NAC use and risk of knee OA.
methodsWe designed a retrospective cohort study from 2000 to 2013. Patients who received oral NAC over 28 days within 1 year after the first prescription were defined as the case group, whereas those without NAC use were considered as candidates of the control group. We adopted 1:4 propensity-score matching by age, sex, index year, and comorbidities to obtain the control group. The primary outcome was a new diagnosis of knee OA during the follow-up period.
resultsOur study sample comprised 12,928 people who used NAC and 51,715 NAC nonusers. NAC users had a significantly higher incidence of osteoarthritis (adjusted hazard ratio: 1.42, P < .001) than did NAC nonusers. Also, in analyses stratified by age group and sex, all subgroups exhibited a significantly higher incidence of knee osteoarthritis (P < .0001) among NAC users than among NAC nonusers. The use of oral NAC was associated with nearly four-fold increased the risk of knee OA in the young age group.
conclusionsLong-term use of oral NAC is associated with a higher risk of knee OA.
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