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Antioxidant therapy for patients with chronic pancreatitis: A systematic review and meta-analysis.
Clin Nutr 2015; 34(4):627-34CN

Abstract

BACKGROUND & AIMS

Chronic pancreatitis is a progressive, inflammatory disease of pancreas characterized by significant abdominal pain, malabsorption, and diabetes mellitus. Antioxidant therapy has been proposed as an effective treatment for painful chronic pancreatitis. We performed a meta-analysis of trials in which antioxidant therapy was compared with placebo in chronic pancreatitis.

METHODS

We searched six databases to identify relevant trials. Results are expressed as risk ratio (RR) or standardized mean difference (SMD) with accompanying 95% confidence intervals (CI). The meta-analysis was performed with the fixed-effects model or random-effects model according to heterogeneity.

RESULTS

Eight studies including 573 patients met the inclusion criteria. A meta-analysis of these studies revealed that the intervention of antioxidants was associated with a significant increase in patients with pain relief (RR, 2.15; 95% CI, 1.72-2.69; P < 0.00001), and a significant decrease in patients' need for analgesics (RR, 0.56; 95% CI, 0.40-0.78; P = 0.0006). For pain score, antioxidants improved pain tolerance in chronic pancreatitis patients (SMD: -0.41; 95% CI: -0.83 to -0.10; P = 0.0005). Additionally, antioxidants may cause some adverse reactions (RR, 4.22; 95% CI: 2.17-8.20; P < 0.0001).

CONCLUSIONS

Based on current evidence, oxidative stress may play an important role in the pathophysiology of chronic pancreatitis, and administration of antioxidants to patients with painful chronic pancreatitis is effective in relieving pain. Antioxidant supplements may be advocated as one medical therapy for chronic pancreatitis patients with low antioxidant capacity in their blood.

Authors+Show Affiliations

Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou 310003, PR China.Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou 310003, PR China.Department of Anorectal Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, PR China.Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou 310003, PR China.Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou 310003, PR China. Electronic address: shusenzheng@zju.edu.cn.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

25035087

Citation

Zhou, Dongkai, et al. "Antioxidant Therapy for Patients With Chronic Pancreatitis: a Systematic Review and Meta-analysis." Clinical Nutrition (Edinburgh, Scotland), vol. 34, no. 4, 2015, pp. 627-34.
Zhou D, Wang W, Cheng X, et al. Antioxidant therapy for patients with chronic pancreatitis: A systematic review and meta-analysis. Clin Nutr. 2015;34(4):627-34.
Zhou, D., Wang, W., Cheng, X., Wei, J., & Zheng, S. (2015). Antioxidant therapy for patients with chronic pancreatitis: A systematic review and meta-analysis. Clinical Nutrition (Edinburgh, Scotland), 34(4), pp. 627-34. doi:10.1016/j.clnu.2014.07.003.
Zhou D, et al. Antioxidant Therapy for Patients With Chronic Pancreatitis: a Systematic Review and Meta-analysis. Clin Nutr. 2015;34(4):627-34. PubMed PMID: 25035087.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antioxidant therapy for patients with chronic pancreatitis: A systematic review and meta-analysis. AU - Zhou,Dongkai, AU - Wang,Weilin, AU - Cheng,Xiaofei, AU - Wei,Jianfeng, AU - Zheng,Shusen, Y1 - 2014/07/05/ PY - 2014/03/15/received PY - 2014/07/01/accepted PY - 2014/7/19/entrez PY - 2014/7/19/pubmed PY - 2016/3/26/medline KW - Antioxidant KW - Chronic pancreatitis KW - Meta-analysis KW - Pain SP - 627 EP - 34 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 34 IS - 4 N2 - BACKGROUND & AIMS: Chronic pancreatitis is a progressive, inflammatory disease of pancreas characterized by significant abdominal pain, malabsorption, and diabetes mellitus. Antioxidant therapy has been proposed as an effective treatment for painful chronic pancreatitis. We performed a meta-analysis of trials in which antioxidant therapy was compared with placebo in chronic pancreatitis. METHODS: We searched six databases to identify relevant trials. Results are expressed as risk ratio (RR) or standardized mean difference (SMD) with accompanying 95% confidence intervals (CI). The meta-analysis was performed with the fixed-effects model or random-effects model according to heterogeneity. RESULTS: Eight studies including 573 patients met the inclusion criteria. A meta-analysis of these studies revealed that the intervention of antioxidants was associated with a significant increase in patients with pain relief (RR, 2.15; 95% CI, 1.72-2.69; P < 0.00001), and a significant decrease in patients' need for analgesics (RR, 0.56; 95% CI, 0.40-0.78; P = 0.0006). For pain score, antioxidants improved pain tolerance in chronic pancreatitis patients (SMD: -0.41; 95% CI: -0.83 to -0.10; P = 0.0005). Additionally, antioxidants may cause some adverse reactions (RR, 4.22; 95% CI: 2.17-8.20; P < 0.0001). CONCLUSIONS: Based on current evidence, oxidative stress may play an important role in the pathophysiology of chronic pancreatitis, and administration of antioxidants to patients with painful chronic pancreatitis is effective in relieving pain. Antioxidant supplements may be advocated as one medical therapy for chronic pancreatitis patients with low antioxidant capacity in their blood. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/25035087/Antioxidant_therapy_for_patients_with_chronic_pancreatitis:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(14)00178-2 DB - PRIME DP - Unbound Medicine ER -