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Antioxidant therapy for pain reduction in patients with chronic pancreatitis: a systematic review and meta-analysis.

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.

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  • 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.

    Source

    Pancreas 44:5 2015 Jul pg 812-8

    MeSH

    Abdominal Pain
    Adult
    Analgesics
    Antioxidants
    Chi-Square Distribution
    Humans
    Odds Ratio
    Oxidative Stress
    Pain Measurement
    Pancreatitis, Chronic
    Risk Factors
    Treatment Outcome

    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 -