Is There Enough Evidence to Support Use of <i>N</i>-Acetylcysteine in Contrast-Induced Nephropathy?
Authors: Giuseppe Ferrante, Didier Locca, Peter Barlis
Journal: Annals of Internal Medicine (2008)

Letters5 August 2008Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy?Giuseppe Ferrante, MD, Didier Locca, MD, and Peter Barlis, MDGiuseppe Ferrante, MDFrom Catholic University of the Sacred Heart, Rome 00168, Italy; Royal Brompton Hospital, London SW36NP, United Kingdom; and Northern Hospital, Epping, Victoria 3076, Australia.Search for more papers by this author, Didier Locca, MDFrom Catholic University of the Sacred Heart, Rome 00168, Italy; Royal Brompton Hospital, London SW36NP, United Kingdom; and Northern Hospital, Epping, Victoria 3076, Australia.Search for more papers by this author, and Peter Barlis, MDFrom Catholic University of the Sacred Heart, Rome 00168, Italy; Royal Brompton Hospital, London SW36NP, United Kingdom; and Northern Hospital, Epping, Victoria 3076, Australia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-3-200808050-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the meta-analysis by Kelly and colleagues (1), in which the authors assessed the effectiveness of several drugs, including N-acetylcysteine and theophylline, in preventing contrast-induced nephropathy. They assessed a total of 41 studies and concluded that N-acetylcysteine is the most effective agent for preventing contrast-induced nephropathy (1). The authors should be commended in undertaking such a comprehensive review of the literature. However, several issues, particularly with the methods adopted in the meta-analysis, need to be considered before the results are accepted as truly representative of “real-world” practice. The treatment effect estimates from the selected ...References1. Kelly AM, Dwamena B, Cronin P, Bernstein SJ, Carlos RC. Meta-analysis: effectiveness of drugs for preventing contrast-induced nephropathy. Ann Intern Med. 2008;148:284-94. [PMID: 18283206] LinkGoogle Scholar2. Altman DG, Bland JM. Interaction revisited: the difference between two estimates. BMJ. 2003;326:219. [PMID: 12543843] CrossrefMedlineGoogle Scholar3. Bucher HC, Guyatt GH, Griffith LE, Walter SD. The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J Clin Epidemiol. 1997;50:683-91. [PMID: 9250266] CrossrefMedlineGoogle Scholar4. Song F, Altman DG, Glenny AM, Deeks JJ. Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses. BMJ. 2003;326:472. [PMID: 12609941] CrossrefMedlineGoogle Scholar5. Fleiss JL. The Design and Analysis of Clinical Experiments. Hoboken, NJ: J Wiley; 1986:100-2. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Catholic University of the Sacred Heart, Rome 00168, Italy; Royal Brompton Hospital, London SW36NP, United Kingdom; and Northern Hospital, Epping, Victoria 3076, Australia.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Effectiveness of Drugs for Preventing Contrast-Induced Nephropathy Aine M. Kelly , Ben Dwamena , Paul Cronin , Steven J. Bernstein , and Ruth C. Carlos Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Otavio Berwanger Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Aine M. Kelly , Ben Dwamena , and Ruth C. Carlos Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Hariprasad Trivedi Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Denise A. Gonzales , Robert A. Star , Steven J. Kern , Charles Natanson , and Robert L. Danner Correction: Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Metrics 5 August 2008Volume 149, Issue 3Page: 214-215KeywordsConflicts of interestDrugs ePublished: 5 August 2008 Issue Published: 5 August 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...