The Pharmacodynamic Effect of N-Acetylcysteine as Adjunctive Therapy in Mild Systemic Lupus Erythematosus Patients

K Tewthanom¹, S Janwityanujit², K Totemchockchyakarn² and D Panomvana^3*

¹Department of Pharmacy, Faculty of Pharmacy, Silpakorn University,  Nakhon Pathom, 73000, ²Division of Allergy, Immulogy and Rheumatology, Department  of Medicine,  Faculty of Medicine, Ramathibodi  Hospital, Mahidol University, Bangkok 10400, ³Department of Pharmacy Practice, Faculty of Pharmaceutical Sceinces, Chulalongkorn University, Bangkok 10330, Thailand.

Received: 24 September 2010                                             Revised accepted: 8 February 2011

Tropical Journal of Pharmaceutical Research, April 2011; 10(2): 141-146

Abstract

Purpose: To evaluate the pharmacodynamic effect of N-acetylcysteine (NAC) in mild systemic lupus erythematosus (SLE) patients in order to implement NAC as adjunctive therapy in SLE population.

Methods: Forty mild SLE patients were randomly allocated to receive 1800 mg of NAC with SLE standard therapy or receive standard therapy alone.  Follow up was performed at 2 weeks, then every month up to 6 months.  Glutathione GSH and malondialdehyde (MDA), a lipid peroxidation product in plasma, were measured at each visit; clinical symptoms were also evaluated.

Results: Supplementation with 1800 mg of NAC did not significantly (p > 0.05) affect GSH level; however, MDA level was significantly (p < 0.05) decreased and the number of patients who could tapper prednisolone dosage was higher in the NAC group than in the control group. 

Conclusion: Administration of NAC may be beneficial in mild SLE patients in terms of decreasing lipid peroxidation. However, this conclusion does not apply to the effect of NAC at different dosages for moderate and severe SLE. Further studies are required in this regard.

Keywords:  Pharmacodynamics, N-Acetylcysteine, Systemic lupus erythematosus, Adjunctive therapy.