What is it about?

We compared the eff i c acy of p irfenidone plus inhaled N acetylcysteine with results for pirfenidone alone for idiopathic pulmonary fibrosis . Combination treatment with inhaled N acetylcysteine and pirfenidone is likely to result in worse outcomes for IPF .

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Why is it important?

The efficacy and tolerability of combination therapy with an antifibrotic agent and inhaled N-acetylcysteine are unclear. This study th erefore compared the efficacy and safety of combination treatment with pirfenidone and inhaled N-acetylcysteine 352.4mg twice daily with the results for pirfenidone alone for treatment of IPF over a 48 week treatment period


The present results indicate that inhaled N acetylcysteine, as administered in this trial, should not be used to treat IPF. Present and previous results indicate that we should not use off-label N acetylcysteine or conduct a new clinical trial without genetic analysis before patient selection.

Susumu Sakamoto
Toho Daigaku

Read the Original

This page is a summary of: Pirfenidone plus inhaled N-acetylcysteine for idiopathic pulmonary fibrosis: a randomised trial, European Respiratory Journal, July 2020, European Respiratory Society (ERS), DOI: 10.1183/13993003.00348-2020.
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