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A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis.
Gastroenterology 2009; 136(1):149-159.e2G

Abstract

BACKGROUND & AIMS

Oxidative stress has been implicated in the pathophysiology of chronic pancreatitis (CP). We evaluated the effects of antioxidant supplementation on pain relief, oxidative stress, and antioxidant status in patients with CP.

METHODS

In a placebo-controlled double blind trial, consecutive patients with CP were randomized to groups that were given placebo or antioxidants for 6 months. The primary outcome measure was pain relief, and secondary outcome measures were analgesic requirements, hospitalization, and markers of oxidative stress (thiobarbituric acid-reactive substances [TBARS]) and antioxidant status (ferric-reducing ability of plasma [FRAP]).

RESULTS

Patients (age 30.5+/-10.5 years, 86 male, 35 alcoholic, and 92 with idiopathic CP) were assigned to the placebo (n=56) or antioxidant groups (n=71). After 6 months, the reduction in the number of painful days per month was significantly higher in the antioxidant group compared with the placebo group (7.4+/-6.8 vs 3.2+/-4, respectively; P< .001; 95% CI, 2.07, 6.23). The reduction in the number of analgesic tablets per month was also higher in the antioxidant group (10.5+/-11.8 vs 4.4+/-5.8 respectively; P= .001; 95% CI, 2.65, 9.65). Furthermore, 32% and 13% of patients became pain free in the antioxidant and placebo groups, respectively (P= .009). The reduction in the level of TBARS and increase in FRAP were significantly higher in the antioxidant group compared with the placebo group (TBARS: placebo 1.2+/-2.7 vs antioxidant 3.5+/-3.4 nmol/mL; P= .001; 95% CI 0.96, 3.55; FRAP: placebo -5.6+/-154.9 vs antioxidant 97.8+/-134.9 microMFe(+2) liberated, P= .001, 95% CI 44.98, 161.7).

CONCLUSIONS

Antioxidant supplementation was effective in relieving pain and reducing levels of oxidative stress in patients with CP.

Authors+Show Affiliations

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18952082

Citation

Bhardwaj, Payal, et al. "A Randomized Controlled Trial of Antioxidant Supplementation for Pain Relief in Patients With Chronic Pancreatitis." Gastroenterology, vol. 136, no. 1, 2009, pp. 149-159.e2.
Bhardwaj P, Garg PK, Maulik SK, et al. A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology. 2009;136(1):149-159.e2.
Bhardwaj, P., Garg, P. K., Maulik, S. K., Saraya, A., Tandon, R. K., & Acharya, S. K. (2009). A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. Gastroenterology, 136(1), pp. 149-159.e2. doi:10.1053/j.gastro.2008.09.028.
Bhardwaj P, et al. A Randomized Controlled Trial of Antioxidant Supplementation for Pain Relief in Patients With Chronic Pancreatitis. Gastroenterology. 2009;136(1):149-159.e2. PubMed PMID: 18952082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis. AU - Bhardwaj,Payal, AU - Garg,Pramod Kumar, AU - Maulik,Subir Kumar, AU - Saraya,Anoop, AU - Tandon,Rakesh Kumar, AU - Acharya,Subrat Kumar, Y1 - 2008/09/25/ PY - 2008/06/02/received PY - 2008/09/09/revised PY - 2008/09/18/accepted PY - 2008/10/28/pubmed PY - 2009/2/13/medline PY - 2008/10/28/entrez SP - 149 EP - 159.e2 JF - Gastroenterology JO - Gastroenterology VL - 136 IS - 1 N2 - BACKGROUND & AIMS: Oxidative stress has been implicated in the pathophysiology of chronic pancreatitis (CP). We evaluated the effects of antioxidant supplementation on pain relief, oxidative stress, and antioxidant status in patients with CP. METHODS: In a placebo-controlled double blind trial, consecutive patients with CP were randomized to groups that were given placebo or antioxidants for 6 months. The primary outcome measure was pain relief, and secondary outcome measures were analgesic requirements, hospitalization, and markers of oxidative stress (thiobarbituric acid-reactive substances [TBARS]) and antioxidant status (ferric-reducing ability of plasma [FRAP]). RESULTS: Patients (age 30.5+/-10.5 years, 86 male, 35 alcoholic, and 92 with idiopathic CP) were assigned to the placebo (n=56) or antioxidant groups (n=71). After 6 months, the reduction in the number of painful days per month was significantly higher in the antioxidant group compared with the placebo group (7.4+/-6.8 vs 3.2+/-4, respectively; P< .001; 95% CI, 2.07, 6.23). The reduction in the number of analgesic tablets per month was also higher in the antioxidant group (10.5+/-11.8 vs 4.4+/-5.8 respectively; P= .001; 95% CI, 2.65, 9.65). Furthermore, 32% and 13% of patients became pain free in the antioxidant and placebo groups, respectively (P= .009). The reduction in the level of TBARS and increase in FRAP were significantly higher in the antioxidant group compared with the placebo group (TBARS: placebo 1.2+/-2.7 vs antioxidant 3.5+/-3.4 nmol/mL; P= .001; 95% CI 0.96, 3.55; FRAP: placebo -5.6+/-154.9 vs antioxidant 97.8+/-134.9 microMFe(+2) liberated, P= .001, 95% CI 44.98, 161.7). CONCLUSIONS: Antioxidant supplementation was effective in relieving pain and reducing levels of oxidative stress in patients with CP. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/18952082/A_randomized_controlled_trial_of_antioxidant_supplementation_for_pain_relief_in_patients_with_chronic_pancreatitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(08)01697-1 DB - PRIME DP - Unbound Medicine ER -