BMC Pulmonary Medicine (Sep 2024)

The effect of nebulized N-acetylcysteine on the phlegm of chronic obstructive pulmonary disease: the NEWEST study

  • Chin Kook Rhee,
  • Seong Yong Lim,
  • Won-Yeon Lee,
  • Ji Ye Jung,
  • Yong Bum Park,
  • Chang Youl Lee,
  • Yong Il Hwang,
  • Jin Woo Song,
  • Won-Il Choi,
  • Kwang Ha Yoo,
  • Ki Uk Kim,
  • Yu-Il Kim,
  • Tae-Hyung Kim,
  • Seong Ju Park,
  • Kyeong-Cheol Shin,
  • Soo-Jung Um,
  • Hyoung Kyu Yoon,
  • Ho Sung Lee,
  • Deog Kyeom Kim,
  • Ah Young Leem,
  • on Behalf of the Korean Pulmonary Rehabilitation Study Group

DOI
https://doi.org/10.1186/s12890-024-03243-y
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 8

Abstract

Read online

Abstract Background Phlegm is prevalent symptom in patients with chronic obstructive pulmonary disease (COPD). Few studies have investigated the effectiveness of N-acetylcysteine (NAC) nebulizer therapy in COPD patients. We evaluated the effect of nebulized NAC on the improvement of phlegm symptom in COPD patients. Methods This was a 12-week, prospective, single-arm, open-label, phase IV multi-center trial (NCT05102305, Registration Date: 20-October-2021). We enrolled patients aged ≥ 40 years with post bronchodilator forced expiratory volume in one second/forced vital capacity (FEV1/FVC) < 0.7 and COPD assessment test (CAT) phlegm score ≥ 2; the patients were current or ex-smoker with smoking pack-years ≥ 10. The primary endpoint was to determine the change in CAT phlegm score at 12 weeks compared to the baseline. Patients were assessed at baseline, 4, 8, and 12 weeks of treatment using the CAT score. Results In total, 100 COPD patients were enrolled from 10 hospitals. The mean age of the patients was 71.42 ± 8.20 years, with 19.78% being current-smokers and 80.22% being ex-smokers. The mean smoking pack-years was 40.32 ± 35.18. The mean FVC, FEV1, and FEV1/FVC were 3.94 L (75.44%), 2.22 L (58.50%), and 0.53, respectively. The CAT phlegm score at baseline was 3.47 ± 1.06, whereas after 12 weeks of nebulized NAC it significantly decreased to 2.62 ± 1.30 (p < 0.01). More than half (53.5%) of the patients expressed satisfaction with the effects of nebulized NAC therapy. Adverse events occurred in 8 (8.0%) patients. Notably, no serious adverse drug reactions were reported. Conclusion In this study, we have established the effectiveness and safety of nebulized NAC over 12 weeks.

Keywords