Skip to main content
Evidence-Based Supplement Research
Evidence-Based Supplement Research
Pillser
Search
Sign UpLog In

A Pilot Study to Evaluate the Effects of Oral N-Acetyl Cysteine on Inflammatory and Oxidative Stress Biomarkers in Rheumatoid Arthritis.

  • 2019-07-31
  • Current rheumatology reviews 15(3)
    • Ghazal Hashemi
    • Mahtabalsadat Mirjalili
    • Zahra Basiri
    • Ahmad Tahamoli-Roudsari
    • Nejat Kheiripour
    • Maryam Shahdoust
    • Akram Ranjbar
    • Maryam Mehrpooya
    • Sara Ataei

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 23
Population
42 patients with RA
Methods
Adjunct to standard treatment, NAC 600 mg twice daily vs placebo twice daily for 12 weeks
Duration
12 weeks
Funding
Unclear

Background

Rheumatoid Arthritis (RA) is a common inflammatory disease of the joints. Due to the importance of inflammation and oxidative stress in the pathogenesis of RA, drugs that have anti-oxidant and anti-inflammatory properties, such as N-acetyl Cysteine (NAC), can be used as adjunctive therapy in patients with RA.

Aims

The aim of this study was to evaluate the effects of oral NAC on inflammatory cytokines and oxidative stress in patients with RA.

Methods

Adjunct to standard treatment, the NAC group (23 patients) received 600 mg of NAC twice daily and the placebo group (19 patients) received identical placebo twice daily for 12 weeks. Serum levels of Total Oxidant Status (TOS), Total Antioxidant Capacity (TAC), nitric oxide (NO), Total Thiol Groups (TTG), Malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), interleukin- 6 (IL-6), C-reactive Protein (CRP), and Erythrocyte Sedimentation Rate (ESR) were measured at baseline and at the end of the study.

Results

Results showed that in the NAC group, the serum levels of MDA, NO, IL-6, TNF-α, ESR and CRP were significantly lower than the baseline. Also, the serum level of TAC and TTG, as antioxidant parameters, increased significantly. However, only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study.

Conclusion

According to the results of this study, oral NAC can significantly reduce the several oxidative stress factors and inflammatory cytokines. These results need to be confirmed in larger studies while considering clinical outcomes of RA patients.

Research Insights

  • N-Acetyl Cysteine→Improved Antioxidant Capacity

    only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study

    Effect
    Neutral
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Improved Thiol Group Level

    only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study

    Effect
    Beneficial
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Increased Total Serum Antioxidant Capacity

    Results showed that in the NAC group, the serum levels of MDA, NO, IL-6, TNF-α, ESR and CRP were significantly lower than the baseline. Also, the serum level of TAC and TTG, as antioxidant parameters, increased significantly. However, only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study.

    Effect
    Beneficial
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Increased Total Thiol Level

    Results showed that in the NAC group, the serum levels of MDA, NO, IL-6, TNF-α, ESR and CRP were significantly lower than the baseline. Also, the serum level of TAC and TTG, as antioxidant parameters, increased significantly. However, only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study.

    Effect
    Beneficial
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Reduced C-Reactive Protein Levels

    only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study

    Effect
    Neutral
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Reduced Erythrocyte Sedimentation Rate

    only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study

    Effect
    Neutral
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Reduced Interleukin-6 Levels

    only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study

    Effect
    Neutral
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Reduced Malondialdehyde

    only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study

    Effect
    Beneficial
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Reduced Nitric Oxide Level

    only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study

    Effect
    Beneficial
    Effect size
    Small
    Dose
    600 mg twice daily
  • N-Acetyl Cysteine→Reduced Tumor Necrosis Factor Alpha

    only NO, MDA and TTG showed a significant difference in the NAC group as compared to the placebo group at the end of study

    Effect
    Neutral
    Effect size
    Small
    Dose
    600 mg twice daily
Back to top