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The prevailing medical advice emphasises informed decision-making, individualised assessment, and appropriate monitoring rather than blanket approval or prohibition

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Acknowledgments The authors extend their appreciation to Prince Sattam bin Abdulaziz University for funding this research work through the project number (PSAU/2025/01/32552)

We also highlight emerging opportunities such as new ferroptosis-inducing agents, biomarker-guided patient selection and rational combinations with chemotherapy, radiotherapy, targeted agents or immunotherapies

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NAC significantly reduced markers like morning stiffness, disease activity score, nitric oxide, fasting blood sugar, and increased HDL cholesterol, although not all improvements were significantly different from the placebo group