In the Journals

Patients with chronic pancreatitis did not benefit from antioxidant therapy

Treatment with antioxidants did not reduce pain or improve quality of life in patients with chronic pancreatitis in a recent study.

In the double blind, controlled trial, researchers randomly assigned 70 patients with chronic pancreatitis to either antioxidant therapy (Antox version 1.2, Pharma Nord UK) (n=33) or placebo (n=37) for 6 months. Change in the degree of pain experienced by participants was measured on an 11-point scale, with participants reporting their pain levels during clinic visits and keeping a daily record. Other evaluated factors included antioxidant levels, rates of hospitalization because of pancreas-related issues and incidence of adverse events.

Pain reduction scores across 6 months were larger in the treated group (2.33 vs. 1.97), but the difference was not statistically significant (P=.509). Patient diaries also indicated similar daily mean pain scores (3.05 among placebo patients and 2.93 in the treated group, P=.808 for difference). Severity of pain according to Brief Pain Inventory scores were similar between the two groups. Quality of life as indicated by patients’ responses to questionnaires, as well as incidence of hospitalization, outpatient doctor visits and opiate use, were similar between groups.

Adverse events were experienced by eight patients in the treated group and one in the placebo group. Seven events were mild and included heartburn with nausea and bad taste. One patient experienced convulsions related to hepatic encephalopathy and was hospitalized, and one participant reported occasional diarrhea and increased bowel movements. No participants in either group required surgery, and no treated patients required alternative therapies during the study.

“Despite the lack of a strong evidence base, micronutrient antioxidant therapy has for more than 30 years been regarded as an alternative paradigm for chronic pancreatitis, and continues to be advocated strongly by its supporters,” the researchers wrote. “When patients present with abdominal pain, with clinical, radiologic and physiological evidence of chronic pancreatitis, micronutrient antioxidant therapy with Antox is not likely to contribute to any reduction in pain or improvement in quality of life.”

Treatment with antioxidants did not reduce pain or improve quality of life in patients with chronic pancreatitis in a recent study.

In the double blind, controlled trial, researchers randomly assigned 70 patients with chronic pancreatitis to either antioxidant therapy (Antox version 1.2, Pharma Nord UK) (n=33) or placebo (n=37) for 6 months. Change in the degree of pain experienced by participants was measured on an 11-point scale, with participants reporting their pain levels during clinic visits and keeping a daily record. Other evaluated factors included antioxidant levels, rates of hospitalization because of pancreas-related issues and incidence of adverse events.

Pain reduction scores across 6 months were larger in the treated group (2.33 vs. 1.97), but the difference was not statistically significant (P=.509). Patient diaries also indicated similar daily mean pain scores (3.05 among placebo patients and 2.93 in the treated group, P=.808 for difference). Severity of pain according to Brief Pain Inventory scores were similar between the two groups. Quality of life as indicated by patients’ responses to questionnaires, as well as incidence of hospitalization, outpatient doctor visits and opiate use, were similar between groups.

Adverse events were experienced by eight patients in the treated group and one in the placebo group. Seven events were mild and included heartburn with nausea and bad taste. One patient experienced convulsions related to hepatic encephalopathy and was hospitalized, and one participant reported occasional diarrhea and increased bowel movements. No participants in either group required surgery, and no treated patients required alternative therapies during the study.

“Despite the lack of a strong evidence base, micronutrient antioxidant therapy has for more than 30 years been regarded as an alternative paradigm for chronic pancreatitis, and continues to be advocated strongly by its supporters,” the researchers wrote. “When patients present with abdominal pain, with clinical, radiologic and physiological evidence of chronic pancreatitis, micronutrient antioxidant therapy with Antox is not likely to contribute to any reduction in pain or improvement in quality of life.”