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While these findings are encouraging, the absence of randomization and the inclusion of multiple active ingredients make it difficult to attribute the observed effects specifically to the proposed triad

Medical professionals may recommend periodic reassessment of treatment goals and effectiveness

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doi:10.1007/s11011-013-9435-x, PMID: 24557875 Sadowska AM, Manuel-Y-Keenoy B, De Backer WA (2007) Antioxidant and anti-inflammatory efficacy of NAC in the treatment of COPD: discordant in vitro and in vivo dose-effects: a review