Tier 1 — highest

Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure

William M Lee, Linda S Hynan, Lorenzo Rossaro, Robert J Fontana, R Todd Stravitz, Anne M Larson, Timothy J Davern 2nd, Natalie G Murray, Timothy McCashland, Joan S Reisch, Patricia R Robuck, Acute Liver Failure Study Group
Gastroenterology 2009 137(3):856-864.e1

Bibliography

PubMed
PMID 19524577
PubMed Central
PMC3189485
DOI
10.1053/j.gastro.2009.06.006
Funding
Funding disclosure was not located in the indexed record reviewed; consult the source publication for the full funding statement.
Competing interests
Competing-interest disclosure was not located in the indexed record reviewed; consult the source publication for the full declaration.

Study snapshot

DesignProspective double-blind randomized placebo-controlled trial
ModelHuman
Sample173 patients
InterventionIntravenous NAC versus placebo for 72 hours
Duration72 hours; outcomes assessed at 3 weeks
EndpointsOverall survival; Transplant-free survival; Liver transplantation

What the study showed, in plain terms

Pivotal randomized trial exploring NAC beyond acetaminophen poisoning in acute liver failure.

Key findings

Overall survival was not significantly different, but transplant-free survival improved in patients with early coma grades I-II.

What this study can and cannot tell us

Benefit was confined to a subgroup with early encephalopathy; advanced coma grades did not benefit.

Editorial review

Reviewed by the Biohack Blueprint research team

Last verified

Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology