Clinical efficacy and quality of life effect of acetylcysteine plus pirfenidone in patients with pulmonary fibrosis

Rong Zhang; Zhanshuai Song; Yan Guan; Juan Zhang; Jianfang Zou; Yingxin Sun; Hua Shao

Clinical efficacy and quality of life effect of acetylcysteine plus pirfenidone in patients with pulmonary fibrosis

Am J Transl Res. 2022 Aug 15;14(8):5660-5668. eCollection 2022.

Authors

Rong Zhang¹, Zhanshuai Song¹, Yan Guan², Juan Zhang¹, Jianfang Zou¹, Yingxin Sun³, Hua Shao¹

Affiliations

¹ Occupational Diseases Branch, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences Jinan 250000, P. R. China.
² Department of Internal Medicine, Shandong Tumor Hospital Jinan 250000, P. R. China.
³ Laboratory of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine Jinan 250000, P. R. China.

PMID: 36105040
PMCID: PMC9452344

Abstract

Objective: To study the clinical efficacy of acetylcysteine combined with pirfenidone in patients with pulmonary fibrosis (PF).

Methods: A total of 114 PF patients admitted from January 2018 to January 2019 were retrospectively analyzed. Among them, 64 patients treated with acetylcysteine combined with pirfenidone were classified into a research group, and the other 50 treated with acetylcysteine combined with budesonide were assigned into a control group. The clinical efficacy and total effectiveness rate of the two groups were compared after 6 months of therapy. The quality of life (QoL) in the two groups before and after treatment was evaluatedusing Asthma Therapy Assessment Questionnaire for idiopathic pulmonary fibrosis patients (ATAQ-IPF). The 2-year survival of the two groups was compared. Additionally, the incidence of adverse reactions was compared between the two groups. The changes in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), inflammatory factors, and PF markers were compared between the two groups before and after therapy.

Results: There were no significant differences in clinical efficacy or total effectiveness rate (all P > 0.05), serum IL-4, INFγ or IL-6 expression (all P > 0.05), as well as FEV1 and FVC levels (all P > 0.05) after therapy between two groups. After therapy, the research group showed significantly lower PCIII and HA levels, lower ATAQ-IPF scores, and lower total incidence of adverse reactions than the control group (all P < 0.05). In addition, a higher 2-year survival rate was observed in the research group than in the control group (P=0.025).

Conclusion: Acetylcysteine combined with pirfenidone can reduce adverse reactions and improve the QoL and survival time of patients.

Keywords: Acetylcysteine; budesonide; pifenidone; prognosis; pulmonary fibrosis.