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

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