Effect of antioxidant therapy on hospital stay and complications in patients with early acute pancreatitis: a randomised controlled trial

Trop Gastroenterol. Oct-Dec 2009;30(4):201-6.

Abstract

Background: Oxidative stress (OS) in acute pancreatitis (AP) has been pathologically linked with the systemic inflammatory response and antioxidant supplementation may have a clinical benefit.

Methods: In this prospective, randomised open label, controlled pilot study, patients admitted within 72 hours of onset of pain were randomised to receive either placebo (only standard medical treatment; SMT) or antioxidants (vitamin C 500 mg, N-acetyl cysteine 200 mg 8 hourly and antoxyl forte 1 capsule hourly with standard medical treatment; SMT + AO) daily, following informed consent. Patients with co-morbid illness and pregnancy were excluded. Primary efficacy measures were length of hospital stay and complications whilst secondary measures were biochemical markers of oxidative stress (thiobarbituric acid reactive substances [TBARS] and superoxide dismutase [SOD] and total antioxidant capacity [TAC] and vitamin C) at Days 1, 3 and 7.

Results: Of 53 patients, 30 patients were randomised to SMT and 23 patients to SMT + AO. The mean duration of hospital stay in the SMT group (10.3 +/- 7 days) was more compared to SMT + AOT (7.2 +/- 5 days), but was not statistically significant (p=0.07), complications were similar in the 2 groups. At Day 7, OS was significantly lower in the SMT + AO group when compared with the SMT group (TBARS, p=0.05; SOD, p=0.03) with a significant increase in FRAP and vitamin C (p=0.01).

Conclusions: Antioxidant supplementation may decrease the length of hospital stay and complication rate in patients with AP, but a larger clinical trial is needed to support this hypothesis. Further, it decreased the OS and improved the antioxidant status in patients with AP.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / therapeutic use*
  • Acute Disease
  • Adult
  • Antioxidants / therapeutic use*
  • Ascorbic Acid / therapeutic use*
  • Biomarkers / blood
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Oxidative Stress
  • Pancreatitis / complications
  • Pancreatitis / drug therapy*
  • Pilot Projects
  • Placebos
  • Prospective Studies
  • Statistics, Nonparametric
  • Treatment Outcome

Substances

  • Antioxidants
  • Biomarkers
  • Placebos
  • Ascorbic Acid
  • Acetylcysteine