N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol

 

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dc.contributor.author Chughlay, Mohamed en_ZA
dc.contributor.author Kramer, Nicole en_ZA
dc.contributor.author Werfalli, Mahmoud en_ZA
dc.contributor.author Spearman, Wendy en_ZA
dc.contributor.author Engel, Mark E en_ZA
dc.contributor.author Cohen, Karen en_ZA
dc.date.accessioned 2015-12-07T08:51:43Z
dc.date.available 2015-12-07T08:51:43Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Chughlay, M. F., Kramer, N., Werfalli, M., Spearman, W., Engel, M. E., & Cohen, K. (2015). N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol. Systematic Reviews, 4(1), 81. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15646
dc.identifier.uri http://dx.doi.org/10.1186/s13643-015-0075-6
dc.description.abstract BACKGROUND: Drug-induced liver injury (DILI) refers to acute or chronic liver injury that may occur as a consequence of using drugs and herbal or dietary supplements. Specific therapies for DILI are limited. There is considerable evidence for efficacy and safety of N-acetylcysteine (NAC) in management of paracetamol-induced liver injury. More recently, research has explored the use of NAC in non-paracetamol drug-induced liver injury. It is important to summarise the evidence of NAC for non-paracetamol DILI to determine if NAC may be considered a therapeutic option in this condition.METHODS/DESIGN:We will conduct a systematic review of the benefit and harm of NAC in non-paracetamol drug-induced liver injury. Primary and secondary outcomes of interest are pre-specified. Primary outcomes include all-cause mortality, mortality due to DILI, time to normalisation of liver biochemistry (e.g. return of alanine transaminase to <100 U/l and/or international normalized ratio (INR) <1.5) and adverse events. Secondary outcomes include transplantation rate, time to transplantation, transplant-free survival and duration of hospitalisation. We will include randomized controlled trials (RCTs) and prospective cohort studies. RCTs will contribute to the evaluation of safety and efficacy of NAC, whereas, the cohort studies will contribute exclusively to the evaluation of safety. We will search several bibliographic databases (including PubMed, Scopus, CINAHL, CENTRAL), grey literature sources, conference proceedings and ongoing trials. Following data extraction and assessment of the risk of bias, we will conduct a meta-analysis if feasible, as well as subgroup analyses. We will assess and explore clinical and statistical heterogeneity.DISCUSSION:The aim of this review is to provide evidence on the effectiveness and safety of NAC in non-paracetamol DILI. We anticipate that the results could aid health care practitioners, researchers and policymakers in the decision-making regarding the use of NAC in patients with non-paracetamol DILI.SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42014008771 en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source Systematic Reviews en_ZA
dc.source.uri http://www.systematicreviewsjournal.com/ en_ZA
dc.subject.other N-acetylcysteine en_ZA
dc.subject.other Acetylcysteine en_ZA
dc.subject.other Drug-induced en_ZA
dc.subject.other Hepatitis en_ZA
dc.subject.other Liver en_ZA
dc.subject.other Liver failure en_ZA
dc.subject.other Non-paracetamol en_ZA
dc.subject.other Non-acetaminophen en_ZA
dc.title N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2015 Chughlay et al. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Clinical Pharmacology en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Chughlay, M., Kramer, N., Werfalli, M., Spearman, W., Engel, M. E., & Cohen, K. (2015). N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol. <i>Systematic Reviews</i>, http://hdl.handle.net/11427/15646 en_ZA
dc.identifier.chicagocitation Chughlay, Mohamed, Nicole Kramer, Mahmoud Werfalli, Wendy Spearman, Mark E Engel, and Karen Cohen "N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol." <i>Systematic Reviews</i> (2015) http://hdl.handle.net/11427/15646 en_ZA
dc.identifier.vancouvercitation Chughlay M, Kramer N, Werfalli M, Spearman W, Engel ME, Cohen K. N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol. Systematic Reviews. 2015; http://hdl.handle.net/11427/15646. en_ZA
dc.identifier.ris TY - Journal Article AU - Chughlay, Mohamed AU - Kramer, Nicole AU - Werfalli, Mahmoud AU - Spearman, Wendy AU - Engel, Mark E AU - Cohen, Karen AB - BACKGROUND: Drug-induced liver injury (DILI) refers to acute or chronic liver injury that may occur as a consequence of using drugs and herbal or dietary supplements. Specific therapies for DILI are limited. There is considerable evidence for efficacy and safety of N-acetylcysteine (NAC) in management of paracetamol-induced liver injury. More recently, research has explored the use of NAC in non-paracetamol drug-induced liver injury. It is important to summarise the evidence of NAC for non-paracetamol DILI to determine if NAC may be considered a therapeutic option in this condition.METHODS/DESIGN:We will conduct a systematic review of the benefit and harm of NAC in non-paracetamol drug-induced liver injury. Primary and secondary outcomes of interest are pre-specified. Primary outcomes include all-cause mortality, mortality due to DILI, time to normalisation of liver biochemistry (e.g. return of alanine transaminase to <100 U/l and/or international normalized ratio (INR) <1.5) and adverse events. Secondary outcomes include transplantation rate, time to transplantation, transplant-free survival and duration of hospitalisation. We will include randomized controlled trials (RCTs) and prospective cohort studies. RCTs will contribute to the evaluation of safety and efficacy of NAC, whereas, the cohort studies will contribute exclusively to the evaluation of safety. We will search several bibliographic databases (including PubMed, Scopus, CINAHL, CENTRAL), grey literature sources, conference proceedings and ongoing trials. Following data extraction and assessment of the risk of bias, we will conduct a meta-analysis if feasible, as well as subgroup analyses. We will assess and explore clinical and statistical heterogeneity.DISCUSSION:The aim of this review is to provide evidence on the effectiveness and safety of NAC in non-paracetamol DILI. We anticipate that the results could aid health care practitioners, researchers and policymakers in the decision-making regarding the use of NAC in patients with non-paracetamol DILI.SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42014008771 DA - 2015 DB - OpenUCT DO - 10.1186/s13643-015-0075-6 DP - University of Cape Town J1 - Systematic Reviews LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol TI - N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol UR - http://hdl.handle.net/11427/15646 ER - en_ZA


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