Case report: oral antioxidant therapy for the treatment of primary biliary cirrhosis: a pilot study.
BACKGROUND
The symptoms of the chronic cholestatic liver disease primary biliary cirrhosis (PBC), in particular fatigue and chronic pruritus, adversely affect quality of life and respond only poorly to treatment. Recent studies have suggested that oxidative stress may play a role in tissue damage in cholestatic liver disease and may contribute to symptoms, such as fatigue. We have, therefore, examined, in an open-label pilot study, the therapeutic effects of antioxidant medication on the biochemistry and symptomatology of PBC.


METHODS
Patients were randomized to 3 months treatment with a compound antioxidant vitamin preparation (Bio-Antox), four tablets daily (n = 11, group 1), or the combination of Bio-Quinone Q10 (100 mg) with Bio-Antox (n = 13, group 2). Biochemical and symptomatic responses were assessed at 3 months.


RESULTS
Significant improvement in both pruritus and fatigue was seen in the patients in group 2. Mean itch visual analogue score improved from 2.4 +/- 3.0 to 0.4 +/- 0.7 post therapy (P < 0.05) while mean night itch severity score improved from 2.6 +/- 1.9 to 1.3 +/- 0.7 (P < 0.05). Nine of 13 of these patients reported less fatigue, while 10/13 showed an improvement in at least one domain of their Fisk Fatigue Severity Score. No significant improvement in itch and only limited improvement in fatigue were seen in the patients in group 1. No change in biochemical parameters was seen in either group.


CONCLUSIONS
Antioxidant therapy, as a combination of Bio-Antox and Bio-Quinone Q10, may improve the pruritus and fatigue of PBC. This combination of therapy should be investigated further in a double-blind, placebo-controlled trial.
Watson
J P
JP
Centre for Liver Research, University of Newcastle upon Tyne, UK.
Jones
D E
DE
James
O F
OF
Cann
P A
PA
Bramble
M G
MG
D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use; D003067:Coenzymes; D004359:Drug Therapy, Combination; D005221:Fatigue / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008715:Methionine / Q000627:therapeutic use; D008875:Middle Aged; D010865:Pilot Projects; D011537:Pruritus / Q000175:diagnosis / Q000188:drug therapy; D012643:Selenium / Q000627:therapeutic use; D016896:Treatment Outcome; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000627:therapeutic use; D014810:Vitamin E / Q000627:therapeutic use; D019207:beta Carotene / Q000627:therapeutic use
D000975:Antioxidants; D003067:Coenzymes; D019207:beta Carotene; D014451:Ubiquinone; D014810:Vitamin E; D008715:Methionine; C024989:coenzyme Q10; D012643:Selenium; D001205:Ascorbic Acid