A double-blind randomized controlled trial of N-acetylcysteine (NAC) for the treatment of acute exacerbation of chronic obstructive pulmonary disease.

10 According to a study conducted in Hong Kong on patients with stable COPD, 1 year of treatment with high‐dose NAC at 600 mg twice daily improved small airways function in terms of forced expiratory flow from 25% to 75% and forced oscillation technique, and also significantly reduced exacerbation frequency with a decreasing trend in admission rate. 11 In a meta‐analysis, patients treated with NAC had significantly and consistently fewer exacerbations of COPD. 12 The role of NAC was examined in a Delphi consensus study involving 53 COPD experts from 12 countries. 13 Respondents agreed that regular treatment with mucolytic agents could effectively decrease the frequency of exacerbations and the duration of mild‐to‐moderate exacerbations, while delaying the time to first exacerbation and increasing symptom‐free time in COPD patients.

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