An interventional study of N Acetyl Cysteine and Standard supportive care in Acute Liver Failure, sponsored by King Edward Medical University. Recruiting at 1 site in Pakistan. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-08-19.
Sponsored by King Edward Medical University · Not applicable, Interventional, and Treatment
This randomized controlled trial evaluates whether oral N-acetylcysteine (NAC), given alongside standard supportive care, improves survival and reduces mortality in patients with non-acetaminophen-induced acute liver failure (ALF), compared to supportive care alone. Secondary objectives are to assess NAC's effect on length of hospital stay and improvement in liver function tests. Sixty-two adult patients (18-60 years) will be randomized 1:1 to NAC or control, with outcomes assessed at 28 days (survival/mortality) and day 4 (liver function tests).
Acute liver failure carries high mortality, and in resource-limited settings like Pakistan, liver transplantation is often inaccessible, making pharmacologic adjuncts to supportive care important. Prior studies (Nabi et al. 2017; Mumtaz et al. 2009; Parkas et al. 2016) suggest oral NAC may improve survival and shorten hospital stay in non-acetaminophen ALF, though evidence remains limited. This trial will randomly assign eligible patients via computer-generated randomization to receive oral/NG NAC (140 mg/kg every 4 hours for 16 hours, then every 6-8 hours, continued for 3 days) plus standard supportive care, or standard supportive care alone. Standard care includes glucose monitoring, prophylactic antimicrobials, proton pump inhibitors, fluid/electrolyte management, anti-encephalopathy measures as needed, and fresh frozen plasma for bleeding. Patients will be followed for up to 28 days.
96 studies on the registry are indexed under Liver Failure, Acute; 20 are open to participants now.
This study's planned enrollment of 62 is above the median of 44 across 49 interventional studies indexed under Liver Failure, Acute.
Browse Liver Failure, Acute studies →King Edward Medical University is the lead sponsor of 82 studies on the registry; 27 are open to participants now.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.
Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Hepatitis B tests
Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.
Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Oral or nasogastric N-acetylcysteine, 140 mg/kg every 4 hours for the first 16 hours, then every 6-8 hours, continued for 3 days, plus standard supportive care. Intervention: Drug: N-acetylcysteine
Drug: N Acetyl Cysteine
Standard supportive care protocol for acute liver failure (glucose control, antimicrobials, PPIs, fluid/electrolyte management, antiencephalopathy measures, FFP as needed). Intervention: Other: Standard Supportive Care
Other: Standard supportive care
Oral or nasogastric N-acetylcysteine administered at 140 mg/kg every 4 hours for the first 16 hours, followed by 140 mg/kg every 6-8 hours, continued for a total duration of 3 days, given in addition to standard supportive care.
Also known as: NAC
Standard supportive care protocol for acute liver failure (glucose control, antimicrobials, PPIs, fluid/electrolyte management, anti-encephalopathy measures, FFP as needed).
Also known as: Supportive care protocol for liver failure
Survival/Mortality rate
Proportion of patients alive (survival) vs. deceased (mortality) at day 28.
Time frame: 28 days after enrollment
Length of hospital stay
Lenght of Hospital stay from admission to death/discharge.
Time frame: From admission to discharge or death (up to 28 days)
Change in Liver Function Tests
Improvement/Decline in liver function tests from Baseline to day i.e Change in bilirubin, albumin, INR, AST, ALT from baseline to day 4.
Time frame: 4 days
Plan to share: Undecided — My Team hasn't yet decided about a formal data-sharing infrastructure.
No publications or documents are linked to this record.
Started Jul 2026 (actual). Primary completion is estimated for Oct 2026, 2 months after the start.
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Studies of the drug tested here: Acetylcysteine
King Edward Medical University