Efficacy of N-acetylcysteine on idiopathic or postinfective non-cystic fibrosis bronchiectasis: a systematic review and meta-analysis protocol

Ai Luo; Xuemei Liu; Qiongqiong Hu; Mei Yang; Hongli Jiang; Wei Liu

doi:10.1136/bmjopen-2021-053625

Efficacy of N-acetylcysteine on idiopathic or postinfective non-cystic fibrosis bronchiectasis: a systematic review and meta-analysis protocol

BMJ Open. 2022 Mar 31;12(3):e053625. doi: 10.1136/bmjopen-2021-053625.

Authors

Ai Luo^#¹, Xuemei Liu^#^{1

2}, Qiongqiong Hu³, Mei Yang¹, Hongli Jiang¹, Wei Liu⁴

Affiliations

¹ Division of Respiratory Medicine, Department of Integrated Traditional and Western Medicine, Sichuan University of West China Hospital, Chengdu, Sichuan, China.
² Department of Pulmonary Disease, State Key Laboratory of Biotherapy of China, Sichuan University of West China Hospital, Chengdu, Sichuan, China.
³ West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
⁴ Division of Respiratory Medicine, Department of Integrated Traditional and Western Medicine, Sichuan University of West China Hospital, Chengdu, Sichuan, China liuwei0929@wchscu.cn.

^# Contributed equally.

Abstract

Introduction: Non-cystic fibrosis (non-CF) bronchiectasis is a chronic pulmonary disorder that causes destruction and permanent dilatation of the airways, resulting in excessive sputum production, repeated infection and inflammation. A need for high-quality and specialised care has been highlighted in recent years. N-acetylcysteine (NAC) is a widely used mucolytic agent in respiratory diseases that not only possesses a property to enhance secretion clearance, but also exhibits antioxidant and anti-inflammatory effects. However, the efficacy and safety of NAC are not well described in idiopathic or postinfective non-CF bronchiectasis.

Objective: This study aims to evaluate the efficacy and safety of NAC in patients with idiopathic or postinfective non-CF bronchiectasis.

Methods and analysis: PubMed/Medline, Embase, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials will be searched from inception to 1 March 2022 for eligible randomised controlled trials that investigating the effects of NAC on exacerbations, health-related quality of life, lung functions, sputum volume and colour, inflammation markers, exercise capacity and adverse events in patients with idiopathic or postinfective non-CF bronchiectasis, with ongoing trials being identified by searches on the websites of Chinese Clinical Trial Registry and ClinicalTrials.gov. Two independent reviewers will identify eligible studies, two will fulfil the data extraction and three will perform the quality appraisal. To generate more accurate analyses, the Grading of Recommendations Assessment, Development and Evaluation will be used to grade the evidence. χ² test and I² statistic will be used to assess heterogeneity. Subgroup analyses and meta-regression will be used to explore potential sources of heterogeneity. The potential publication bias will be examined using funnel plots.

Ethics and dissemination: No research ethics approval is required in this study because it is a systematic review. The results of this study are expected to be disseminated through peer-reviewed journals and conferences.

Trial registration number: CRD42021239438.

Keywords: chronic airways disease; respiratory infections; thoracic medicine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acetylcysteine* / therapeutic use
Bronchiectasis* / drug therapy
Humans
Meta-Analysis as Topic
Quality of Life
Research Design
Systematic Reviews as Topic

Substances

Acetylcysteine