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Cited by 54

The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.

N-Acetylcysteine for the Management of Non-Acetaminophen Drug-Induced Liver Injury in Adults: A Systematic Review

Sanabria-Cabrera, Judith, Tabbai, Sara, Niu, Hao, Alvarez-Alvarez, Ismael, Licata, Anna, Björnsson, Einar, Andrade, Raul J., Lucena, M. Isabel·2022·Frontiers in Pharmacology
DOI 10.3389/fphar.2022.876868PMC PMC9152180
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Abstract

Introduction: Idiosyncratic drug-induced liver injury (DILI) is a rare adverse reaction to drugs and other xenobiotics. DILI has different grades of severity and may lead to acute liver failure (ALF), for which there is no effective therapy. N-acetylcysteine (NAC) has been occasionally tested for the treatment of non-acetaminophen drug-induced ALF. However, limited evidence for its efficacy and safety is currently available. Our aim was to elucidate the benefit and safety of NAC in DILI and evaluate its hepatoprotective effect. Methods: We conducted a systematic review to evaluate the management and prevention focused on NAC in idiosyncratic DILI. The main outcomes included mortality due to DILI, time to normalization of liver biochemistry, transplant-free survival, and adverse events. We included clinical trials and observational studies, either prospective or retrospective. Results: A total of 11 studies were included after literature screening. All studies had different methodologies, and some of them had important risk of bias that may lead to interpreting their findings with caution. The majority of the studies proved NAC efficacy in a cohort of patients with ALF due to different etiologies, where DILI represented a subgroup. NAC seemed to improve transplant-free survival; however, its benefit was inconclusive in terms of overall survival. With regard to safety, NAC showed an adequate safety profile. In prevention studies, NAC showed a possible hepatoprotective effect; however, this finding is limited by the lack of studies and presence of bias. Conclusion: NAC treatment seems to have some benefit in non-acetaminophen drug-induced liver failure patients with acceptable safety; however, due to the lack of evidence and limitations detected across studies, its benefit must be corroborated in clinical trials with adequate methodology.

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FIGURE 1 Flowchart of the search of publications about the role of NAC in DILI treatment and prevention.
FIGURE 1 Flowchart of the search of publications about the role of NAC in DILI treatment and prevention.CC BY · PubMed Central

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Metadata

Authors
Sanabria-Cabrera, J., Tabbai, S., Niu, H., Alvarez-Alvarez, I., Licata, A., Björnsson, E., Andrade, R. J., & Lucena, M. I.
Venue
Frontiers in Pharmacology
Publisher
Frontiers Media SA
Published
2022-05-17
Volume
13
ISSN
1663-9812
DOI
10.3389/fphar.2022.876868
PMC
PMC9152180
Cited by
54
References
31
Licence
creativecommons.org/licenses/by/4.0/ (vor)

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CoChat. (2026). Citation check: N-Acetylcysteine for the Management of Non-Acetaminophen Drug-Induced Liver Injury in Adults: A Systematic Review. https://app.cochat.ai/papers/10.3389/fphar.2022.876868
The paper
Sanabria-Cabrera, J., Tabbai, S., Niu, H., Alvarez-Alvarez, I., Licata, A., Björnsson, E., Andrade, R. J., & Lucena, M. I. (2022). N-Acetylcysteine for the Management of Non-Acetaminophen Drug-Induced Liver Injury in Adults: A Systematic Review. Frontiers in Pharmacology. https://doi.org/10.3389/fphar.2022.876868

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.