TABLE 6.

Heterogeneity and quality assessment of three clinical trials included in the analysis.

Author (year)	Study design/patient number	Results	Comments/limitations
Keays et al. (1991)	Prospective randomized controlled study, involving 50 patients: 25 NAC–25 control	NAC is safe and effective in fulminant hepatic failure after APAP overdose
Bateman (2014)	Double-blind randomized study, involving 222 patients	In patients with APAP poisoning, a 12-h modified NAC regimen resulted in less vomiting, fewer anaphylactoid reactions, and reduced need for treatment interruption	The open nature of the comparison might have led to observer bias in the assessment of adverse reactions.
	110 standard		The trial was not sufficiently powered to show noninferiority of the modified acetylcysteine regimen for the prevention of hepatotoxic effects
	112 shorter
Morrison et al. (2019)	Randomized study, involving 24 patients	Calmangafodipir was tolerated when combined with NAC and may reduce biomarkers of paracetamol toxicity	The patients were not stratified at randomization by the risk of developing a liver injury. There was a small patient number

NAC, N-acetylcysteine; AE, adverse events; LT, liver transplantation; I.V., intravenous; DILI, drug-induced liver injury; NR, not reported.