Question

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

Answer 1

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

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:

• From the beginning until December 2013, two writers separately performed a thorough literature search.
• The Mantel-Haenszel and DerSimonian-Laird techniques were used to compute the relative risk (RR) and 95% confidence intervals (CIs).

Results:

• There were eight studies totaling 446 patients (234 in the AOT group and 212 in the control group).
• Overall, compared to the control group, CP patients who received AOT saw a substantial decrease in pain (RR, 0.73; 95% CI, 0.58-0.91; P = 0.006).
• Trials with primarily alcoholic CP patients (RR, 0.60; 95% CI, 0.47-0.77; P 0.0001) and studies with patients who were on average     42 years old or older (RR, 0.66; 95% CI, 0.49-0.89; P = 0.006) also shown a substantial advantage of AOT over placebo in the subgroup analysis.

Conclusions:

• This is the first meta-analysis to compile all the evidence that is currently available and demonstrate the value of AOT in reducing pain in CP patients.
• To better identify the patient and illness characteristics favoring response, the ideal formulation, and the duration of AOT, larger studies with longer follow-up are urgently needed.

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