Antioxidative effects of N‐acetylcysteine in patients with β–thalassemia: A quick review on clinical trials

Abstract

Abstract Background and Aims Several studies have highlighted the potent antioxidant properties of N‐acetyl cysteine (NAC). This review aimed to assess the impact of NAC on oxidative stress biomarkers in patients with β‐thalassemia. Methods The review included articles published before 2024 that investigated the effects of NAC on oxidative stress in individuals with β‐thalassemia. A comprehensive search was conducted across various databases, including Scopus, PubMed, Web of Science, Trip, and CENTRAL. Only English‐language clinical trials were considered for inclusion in this review. Besides, the number needed to treat (NNT) was calculated based on the included studies. Results Ninety‐nine articles were retrieved from electronic databases, and after a thorough review, eight articles were selected for comprehensive text analysis. The highest dose of NAC administered was 10 mg/kg/day (equivalent to 600 mg/day) over a period of 3–6 months. All the studies assessing the impact of NAC on oxidative stress indicators in β‐thalassemia patients demonstrated positive effects during the 3‐month follow‐up period. Most estimated NNTs fell into 1–5, suggesting significant clinical therapeutic value in this context. Conclusion The current potency of NAC alone appears to be effective in ameliorating oxidative stress in patients with β‐thalassemia major. While a 3‐month duration seems adequate to demonstrate the antioxidant properties of NAC in this population, larger and well‐designed clinical trials are warranted. Current clinical evidence possesses a high risk of bias.

Keywords

• antioxidants
• N‐acetylcysteine
• oxidative stress
• β–thalassemia