Gene-guided N-acetyl Cysteine to prevent liver damage from TB drugs

Gene-guided N-acetyl Cysteine for Prophylaxis of Anti-tuberculous Drug- Induced Hepatitis: A Randomized Controlled Trial

Phase 4 Interventional Mahidol University · NCT06484530

This study is testing if N-acetylcysteine can help protect the livers of newly diagnosed tuberculosis patients who are at risk of liver damage from their TB medications.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment116 (estimated)
Ages18 Years to 80 Years
SexAll
SponsorMahidol University Academic / other
Locations1 site (Bangkok Noi, Bangkok)
Trial IDNCT06484530 on ClinicalTrials.gov

What this trial studies

This clinical trial investigates the use of N-acetylcysteine (NAC) to prevent hepatotoxicity in patients undergoing treatment for tuberculosis (TB). It focuses on newly diagnosed TB patients who are at risk of liver damage due to standard anti-TB medications, particularly those with the NAT2 slow acetylator phenotype. The study aims to determine if NAC can significantly reduce the incidence of drug-induced hepatitis, which affects a substantial percentage of TB patients. Participants will receive standard TB treatment alongside NAC to assess its protective effects on liver function.

Who should consider this trial

Good fit: Ideal candidates for this study are newly diagnosed tuberculosis patients aged 18 to 80 who are starting standard anti-TB therapy.

Not a fit: Patients with severe liver dysfunction, chronic liver diseases, or those infected with HIV may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly reduce the risk of liver damage in TB patients, improving treatment adherence and outcomes.

How similar studies have performed: Previous studies have shown promising results with NAC in reducing hepatotoxicity among slow acetylators, indicating potential success for this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Patients aged 18 - 80 years old.
* Newly diagnosed tuberculosis patients (both pulmonary and extrapulmonary).
* Received standard anti-tuberculosis medication according to standard regimens (2HRZE/4HR, 2HRE/7HR).
* Willing to participate in the research

Exclusion Criteria:

* Infected with HIV.
* Severe liver dysfunction classified as Child-Pugh B or C.
* Chronic untreated liver diseases such as hepatitis B or C, alcoholic liver disease.
* Abnormal liver function tests including AST \> 1.5 times the upper limit of normal (48 U/L), ALT \> 1.5 times the upper limit of normal (55 U/L), ALP \> upper limit of normal (110 U/L), Total bilirubin \> upper limit of normal (1.2 mg/dL).
* Diagnosed with cancer.
* History of allergy to N-acetylcysteine (NAC).
* Pregnant or breastfeeding.
* Severe comorbidities such as CKD stage 4-5, chronic heart failure, severe pulmonary diseases (COPD, bronchiectasis).

Where this trial is running

Bangkok Noi, Bangkok

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions TuberculosisIsoniazid ToxicityRifampicin ToxicityPyrazinamide Adverse ReactionEthambutol ToxicityNAT2 Slow Acetylator StatusNAT2 Rapid Acetylator StatusNAT2 Polymorphism
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.