Clinical efficacy and quality of life effect of acetylcysteine plus pirfenidone in patients with pulmonary fibrosis.

OBJECTIVE

To study the clinical efficacy of acetylcysteine combined with pirfenidone in patients with pulmonary fibrosis (PF).

METHODS

A total of 114 PF patients admitted from January 2018 to January 2019 were retrospectively analyzed. Among them, 64 patients treated with acetylcysteine combined with pirfenidone were classified into a research group, and the other 50 treated with acetylcysteine combined with budesonide were assigned into a control group. The clinical efficacy and total effectiveness rate of the two groups were compared after 6 months of therapy. The quality of life (QoL) in the two groups before and after treatment was evaluatedusing Asthma Therapy Assessment Questionnaire for idiopathic pulmonary fibrosis patients (ATAQ-IPF). The 2-year survival of the two groups was compared. Additionally, the incidence of adverse reactions was compared between the two groups. The changes in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), inflammatory factors, and PF markers were compared between the two groups before and after therapy.

RESULTS

There were no significant differences in clinical efficacy or total effectiveness rate (all P > 0.05), serum IL-4, INFγ or IL-6 expression (all P > 0.05), as well as FEV1 and FVC levels (all P > 0.05) after therapy between two groups. After therapy, the research group showed significantly lower PCIII and HA levels, lower ATAQ-IPF scores, and lower total incidence of adverse reactions than the control group (all P < 0.05). In addition, a higher 2-year survival rate was observed in the research group than in the control group (P=0.025).

CONCLUSION

Acetylcysteine combined with pirfenidone can reduce adverse reactions and improve the QoL and survival time of patients.