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Antioxidant therapy for pain reduction in patients with chronic pancreatitis: a systematic review and meta-analysis.
Pancreas 2015; 44(5):812-8P

Abstract

OBJECTIVES

Oxidative stress is strongly implicated in the pathogenesis of chronic pancreatitis (CP); however, clinical studies evaluating antioxidant therapy (AOT) in the management of CP pain have yielded conflicting results. The aim of this meta-analysis was to evaluate the efficacy of AOT in pain reduction in CP patients.

METHODS

Two authors independently conducted a comprehensive literature search from inception to December 2013. Relative risk (RR) and 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel and DerSimonian-Laird methods.

RESULTS

Eight studies involving 446 patients (234 in AOT and 212 in control group) were included. Overall, CP patients who received AOT had significant reduction in pain compared with the control group (RR, 0.73; 95% CI, 0.58-0.91; P = 0.006). In the subgroup analysis, studies with predominantly alcoholic CP patients (RR, 0.60; 95% CI, 0.47-0.77; P < 0.0001) and studies with mean age of patients 42 years or older (RR, 0.66; 95% CI, 0.49-0.89; P = 0.006) showed significant benefit of AOT over placebo.

CONCLUSIONS

This is the first meta-analysis to summarize all the available evidence and show benefit of AOT in pain reduction in CP patients. There is a pressing need for well-designed larger studies with longer follow-up to better define the patient and disease factors favoring response, the optimal formulation, and duration of AOT.

Authors+Show Affiliations

From the *Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven; and †Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT.No affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

25882696

Citation

Rustagi, Tarun, and Basile Njei. "Antioxidant Therapy for Pain Reduction in Patients With Chronic Pancreatitis: a Systematic Review and Meta-analysis." Pancreas, vol. 44, no. 5, 2015, pp. 812-8.
Rustagi T, Njei B. Antioxidant therapy for pain reduction in patients with chronic pancreatitis: a systematic review and meta-analysis. Pancreas. 2015;44(5):812-8.
Rustagi, T., & Njei, B. (2015). Antioxidant therapy for pain reduction in patients with chronic pancreatitis: a systematic review and meta-analysis. Pancreas, 44(5), pp. 812-8. doi:10.1097/MPA.0000000000000327.
Rustagi T, Njei B. Antioxidant Therapy for Pain Reduction in Patients With Chronic Pancreatitis: a Systematic Review and Meta-analysis. Pancreas. 2015;44(5):812-8. PubMed PMID: 25882696.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antioxidant therapy for pain reduction in patients with chronic pancreatitis: a systematic review and meta-analysis. AU - Rustagi,Tarun, AU - Njei,Basile, PY - 2015/4/18/entrez PY - 2015/4/18/pubmed PY - 2016/4/8/medline SP - 812 EP - 8 JF - Pancreas JO - Pancreas VL - 44 IS - 5 N2 - OBJECTIVES: Oxidative stress is strongly implicated in the pathogenesis of chronic pancreatitis (CP); however, clinical studies evaluating antioxidant therapy (AOT) in the management of CP pain have yielded conflicting results. The aim of this meta-analysis was to evaluate the efficacy of AOT in pain reduction in CP patients. METHODS: Two authors independently conducted a comprehensive literature search from inception to December 2013. Relative risk (RR) and 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel and DerSimonian-Laird methods. RESULTS: Eight studies involving 446 patients (234 in AOT and 212 in control group) were included. Overall, CP patients who received AOT had significant reduction in pain compared with the control group (RR, 0.73; 95% CI, 0.58-0.91; P = 0.006). In the subgroup analysis, studies with predominantly alcoholic CP patients (RR, 0.60; 95% CI, 0.47-0.77; P < 0.0001) and studies with mean age of patients 42 years or older (RR, 0.66; 95% CI, 0.49-0.89; P = 0.006) showed significant benefit of AOT over placebo. CONCLUSIONS: This is the first meta-analysis to summarize all the available evidence and show benefit of AOT in pain reduction in CP patients. There is a pressing need for well-designed larger studies with longer follow-up to better define the patient and disease factors favoring response, the optimal formulation, and duration of AOT. SN - 1536-4828 UR - https://www.unboundmedicine.com/medline/citation/25882696/Antioxidant_therapy_for_pain_reduction_in_patients_with_chronic_pancreatitis:_a_systematic_review_and_meta_analysis_ L2 - http://Insights.ovid.com/pubmed?pmid=25882696 DB - PRIME DP - Unbound Medicine ER -