He Tingting, Ren Kehui, Xiang Li, Yao Huan, Huang Yucheng, Gao Yongxiang
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Sichuan Provincial Engineering Research Center of Innovative Re-development of Famous Classical Formulas, Pengzhou, Sichuan, China.
Br J Hosp Med (Lond). 2024 Nov 30;85(11):1-16. doi: 10.12968/hmed.2024.0560. Epub 2024 Nov 18.
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease and N-acetylcysteine (NAC) is considered a potential therapeutic agent for RA due to strong antioxidant and anti-inflammatory properties. Therefore, this systematic review and meta-analysis aimed to evaluate the efficacy of NAC as an adjuvant therapy for RA. A systematic search was conducted across five databases from inception to 1 August 2024, including CINAHL, Cochrane Library, EMBASE, PubMed, and Web of Science. The Cochrane risk-of-bias tool for randomized trials was used to assess the quality of the included studies. Sensitivity analysis was performed when significant heterogeneity was identified. Four studies involving 204 patients were included in our meta-analysis. The results indicated that NAC alleviated disease activity in RA patients (Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR): mean difference (MD) = 0.54). Additionally, NAC reduced inflammatory markers (erythrocyte sedimentation rate (ESR): MD = 3.00). However, the beneficial effects of NAC on oxidative stress in RA patients were not observed. This meta-analysis demonstrated the efficacy of NAC in reducing inflammatory markers, improving joint tenderness, and swelling in patients with RA.
类风湿关节炎（RA）是一种炎症性自身免疫性疾病，N-乙酰半胱氨酸（NAC）因其强大的抗氧化和抗炎特性而被认为是RA的一种潜在治疗药物。因此，本系统评价和荟萃分析旨在评估NAC作为RA辅助治疗的疗效。从数据库建立至2024年8月1日，对五个数据库进行了系统检索，包括护理学与健康领域数据库（CINAHL）、考克兰图书馆、荷兰医学文摘数据库（EMBASE）、美国国立医学图书馆生物医学文献数据库（PubMed）和科学引文索引数据库（Web of Science）。采用考克兰随机试验偏倚风险工具评估纳入研究的质量。当发现显著异质性时，进行敏感性分析。我们的荟萃分析纳入了四项涉及204例患者的研究。结果表明，NAC可减轻RA患者的疾病活动度（28个关节疾病活动评分-红细胞沉降率（DAS28-ESR）：平均差（MD）=0.54）。此外，NAC可降低炎症标志物（红细胞沉降率（ESR）：MD = 3.00）。然而，未观察到NAC对RA患者氧化应激的有益作用。这项荟萃分析证明了NAC在降低RA患者炎症标志物、改善关节压痛和肿胀方面的疗效。
