This document contains details from a randomized controlled trial studying the effects of acetylcysteine on idiopathic pulmonary fibrosis (IPF). The trial involved 264 patients with mild to moderate IPF who were randomly assigned to receive either acetylcysteine or a placebo. After 60 weeks, there was no significant difference in decline of forced vital capacity between the two groups. Rates of death and acute exacerbation were also not significantly different. The study concluded that acetylcysteine provided no significant benefits over placebo for preserving lung function in IPF patients.

1. Name- Neera Katyayni
Section- B108
Reg no- 11717308
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2. • Idiopathic disease for which the cause is unknown.
• Absence of proper diagnosis
• Article ; Randomised Trial Of Acetylcysteine in IPF
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3. • An idiopathic disease is any disease with an unknown
cause
• The term ‘idiopathic’ literally means ‘of no known cause’
known that its common in smokers.
• There are many disease which are idiopathic in nature like;
idiopathic pulmonary fibrosis, intestinal pneumonia,
pellucid marginal degeneration, condylar resorption etc
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4. Idiopathic pulmonary fibrosis
• Idiopathic pulmonary fibrosis (IPF) is a type of
chronic lung disease characterized by a progressive and
irreversible decline in lung function.
• It is a type of interstitial lung disease (ILD).
• Symptoms may not be perticular.
• The underlying mechanism involves scarring of the
lungs.
• Complications may include pulmonary
hypertension, heart failure, pneumonia, or pulmonary
embolism.
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8. CAUSE
• The cause of IPF is unknown but certain
environmental factors and exposures have been
shown to increase the risk of getting IPF.
• Cigarette smoking is the most accepted risk factor
for IPF
• Other environmental and occupation exposures
such as exposure to metal dust, wood, coal, silica,
biologic dusts coming from hay dust also show the
increase risk for IPF.
• Viral infections may be associated with IPF and
other fibrotic lung diseases
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9. Symptoms
• Loss of elasticity leading to breathlessness, and a
crackling “Velcrolike” sound when breathing
• Dry cough(persistent cough )
• Tiredness
• Weight loss
• Finger clubbing.
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11. Drawback
• the general approach to treatment is to attempt to
suppress progression with corticosteroids, alone or
in combination with cytotoxic agents such as
azathioprine or cyclophosphamide.
• these compounds only slow the progression of the
disease, they do not act as a cure and cannot halt or
reverse the decline in lung function
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12. discussion
• Diagnosis may be supported by a CT scan or lung
biopsy.
• About 5 million people are affected globally
• Laboratory Tests - No specific serum laboratory
tests are available to diagnose IPF,
• but use of available tests can aid in
differentiating IPF from other diseases and
identifying complications and coexisting entities.
• Routine laboratory tests in the evaluation,
including complete blood cell count, may support
the presence of an infection.
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13. Developing new IPF therapies
• The world urgently needs improved
treatment of IPF. A range of agents are
currently being developed to combat IPF,
targeting various pathways
• One such research Article published on May
18,2014 by Fernando J . Martinez, MD, New
York
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14. Randomized Trial of Acetylcysteine in
Idiopathic Pulmonary Fibrosis
• Background - Acetylcysteine has been
suggested as a beneficial treatment for
idiopathic pulmonary fibrosis.
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15. Method
• - In our initial placebo-controlled trial, we randomly
assigned patients who had IPF with mild-to-
moderate impairment in pulmonary function to
receive acetylcysteine alone; or placebo.
• The trial continued as a two-group study
(acetylcysteine vs. placebo) without other changes;
133 and 131 patients were enrolled in the
Acetylcysteine and placebo groups, respectively.
• The primary outcome was the change in forced
vital capacity (FVC) over a 60-week period.
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17. Result
• At 60 weeks, there was no significant difference in
the change in FVC between the Acetylcysteine
group and the placebo group
(−0.18 liters and −0.19 liters, respectively; P = 0.77).
• In addition, there were no significant differences
between the acetylcysteine group and the placebo
group in the rates of death (4.9% vs. 2.5%, P = 0.30
by the log-rank test) or acute exacerbation (2.3% in
each group, P>0.99).
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18. Conclusion
• As compared with placebo, Acetylcysteine offered
no significant benefit with respect to the
preservation of FVC in patients with idiopathic
pulmonary fibrosis with mild to-moderate
impairment in lung function.
(Funded by the National Heart, Lung, and Blood
Institute and others
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