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N-acetylcysteine for non-paracetamol-induced acute liver failure in children: A systematic review and meta-analysis

Alise D E de Groot, Désanka M Stoppels, Arno R Bourgonje, Willemien F J Hof, Martin C J Kneyber, Daan J Touw, Henkjan J Verkade, Paola Mian
Br J Clin Pharmacol 2026 Online ahead of print

Bibliography

PubMed
PMID 42397304
DOI
10.1002/bcp.70680
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

DesignSystematic review and meta-analysis
ModelHuman
Sample310 NAC-treated children and 242 controls
InterventionNAC versus control in pediatric non-paracetamol acute liver failure
DurationAcute hospital treatment
EndpointsOverall survival; Transplant-free survival

What the study showed, in plain terms

July 2026 pediatric evidence synthesis addressing a controversial extrapolation of NAC beyond acetaminophen poisoning.

Key findings

NAC did not significantly improve overall survival or transplant-free survival in children with non-paracetamol acute liver failure.

What this study can and cannot tell us

Limited randomized evidence, heterogeneous etiologies and wide confidence intervals.

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