IMPACT-NAC: A clinical trial of N-acetylcysteine for adults with severe infection and liver dysfunction

2026-525895-25-00 Therapeutic use (Phase IV) Authorised, recruitment pending

Status Authorised, recruitment pending · 1 EU/EEA countries · 1 sites

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Authorised, recruitment pending
Participants planned 360
Countries 1
Sites 1

Acute infection

To assess the effects of N-acetylcysteine on mortality and hospital length of stay in adults admitted to the emergency department with acute infection or sepsis and evidence of liver dysfunction.

Key facts

Sponsor
Region Hovedstaden
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Bacterial Infections and Mycoses [C01], Diseases [C] - Virus Diseases [C02]
Decision date (initial)
2026-05-22
Transition trial
No
Low-intervention
No
Rare-disease indication
No
Vulnerable population
No

External identifiers

EU CT number
2026-525895-25-00
WHO UTN
U1111-1336-2257

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Efficacy

To assess the effects of N-acetylcysteine on mortality and hospital length of stay in adults admitted to the emergency department with acute infection or sepsis and evidence of liver dysfunction.

Conditions and MedDRA coding

Acute infection

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 3

  1. Age ≥18 years
  2. Documented clinical suspicion of infection
  3. Model for end-stage liver disease (MELD) score ≥9

Exclusion criteria 13

  1. Admitted to hospital >24 hours before randomization
  2. Inability to read and understand Danish to a degree that allows valid informed consent and completion of trial assessments
  3. Involuntary admission under the psychiatric law
  4. Any other condition deemed by the investigator to compromise patient safety or trial integrity (e.g., severe coagulopathy, uncontrolled bleeding, diabetic ketoacidosis)
  5. Expected initiation of palliative care within 48 hours of randomization
  6. Ongoing treatment with nitroglycerin
  7. Any previous severe anaphylaxis
  8. Known allergy to N-acetylcysteine
  9. Ongoing treatment with N-acetylcysteine at randomization
  10. Documented clinical suspicion of bile duct obstruction
  11. Refractory circulatory shock
  12. Inability to provide informed consent
  13. Pregnancy

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Days alive and out of hospital from randomization to day 14

Secondary endpoints 7

  1. Number of participants with one or more serious adverse event within 14 days of randomization
  2. All-cause mortality at day 180
  3. Health-related quality of life (HRQoL) at day 180 using EQ-5D-5L index values
  4. Admission to an intensive care unit (ICU) within 14 days of admission
  5. Duration of antibiotic therapy from randomization to day 14
  6. Time to clinical stability
  7. Days alive and out of hospital from randomization to day 180

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Acetylcysteine

SUB05229MIG · Substance

Active substance
Acetylcysteine
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS INFUSION
Max daily dose
200 mg/kg milligram(s)/kilogram
Max total dose
200 mg/kg milligram(s)/kilogram
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Placebo 1

Sodium Chloride

SUB12581MIG · Substance

Active substance
Sodium Chloride
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS INFUSION
Max daily dose
500 ml millilitre(s)
Max total dose
500 ml millilitre(s)
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Region Hovedstaden

Sponsor organisation
Region Hovedstaden
Address
Blegdamsvej 9
City
Copenhagen Oe
Postcode
2100
Country
Denmark

Scientific contact point

Organisation
Region Hovedstaden
Contact name
Theis Skovsgaard Itenov

Public contact point

Organisation
Region Hovedstaden
Contact name
Theis Skovsgaard Itenov

Third parties 1

OrganisationCity, countryDuties
Region Hovedstaden
ORG-100003705
Frederiksberg, Denmark On site monitoring

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Denmark Authorised, recruitment pending 360 1
Rest of world 0

Investigational sites

Denmark

1 site · Authorised, recruitment pending
Copenhagen University Hospital
Department of Emergency Medicine, Bispebjerg Bakke 23, 2400, Copenhagen Nv

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 8 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol EU CT 2026-525895-25-00 3
Protocol (for publication) D4_Patient facing documents EQ-5D-5L 1
Recruitment arrangements (for publication) K1_Recruitment arrangements 2.1
Subject information and informed consent form (for publication) L1_ICF participant 1
Subject information and informed consent form (for publication) L1_ICF ret til ikke-viden 1
Subject information and informed consent form (for publication) L1_SIS participant 2.1
Subject information and informed consent form (for publication) L2_Other subject information material Dine rettigheder som forsgsperson i forsg med medicin 1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC Acetylcysteine 1

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2026-03-16 Denmark Acceptable
2026-05-21
2026-05-22