Prophylactic and therapeutic efficacy of pyridoxine supplements in the management of hand-foot syndrome during chemotherapy: a meta-analysis

Clin Exp Dermatol. 2015 Apr;40(3):260-70. doi: 10.1111/ced.12538. Epub 2014 Dec 31.


Background: Hand-foot syndrome (HFS) is a common cutaneous side effect of certain systemic chemotherapeutic agents.

Aim: To assess the efficacy of pyridoxine supplements in the management of HFS.

Methods: We searched PubMed, EMBASE and the Cochrane Central Register of Controlled Trials for studies reporting the efficacy of pyridoxine supplements to manage HFS. We performed a meta-analysis using HFS incidence and improvement rates to measure the preventive and treatment efficacy of pyridoxine supplementation.

Results: We assessed eight studies [two retrospective studies, two prospective comparative trials and four randomized controlled trials (RCTs)] for preventive efficacy and three studies (one RCT and two non-RCTs) for treatment efficacy. A random-effects meta-analysis did not find any significant association between prophylactic pyridoxine supplementation and HFS development [relative risk (RR) = 0.95; 95% CI 0.87-1.05) or any significant preventive efficacy against HFS in subgroup meta-analyses of study design, chemotherapeutic agents, pyridoxine dose, HFS severity, publication year or observation period. However, pyridoxine did show significant efficacy in treating HFS (RR = 1.75; 95% CI 1.09-2.80), but did not show efficacy in the only RCT (RR = 1.12; 95% CI 0.58-2.14).

Conclusions: We found no clinical evidence to support the use of pyridoxine supplements to prevent HFS during chemotherapy.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Dietary Supplements*
  • Disease Management
  • Hand-Foot Syndrome / drug therapy*
  • Hand-Foot Syndrome / etiology
  • Hand-Foot Syndrome / prevention & control
  • Humans
  • Prospective Studies
  • Pyridoxine / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Vitamin B Complex / therapeutic use*


  • Antineoplastic Agents
  • Vitamin B Complex
  • Pyridoxine