Oral antioxidant supplementation for fatigue associated with primary biliary cirrhosis: results of a multicentre, randomized, placebo-controlled, cross-over trial.
BACKGROUND
We have previously reported, in an uncontrolled trial, an improvement in fatigue scores in patients with primary biliary cirrhosis given oral antioxidant supplementation. We now present data from a controlled trial.


METHODS
Sixty-one patients with primary biliary cirrhosis-associated fatigue were randomized into a double-blind, placebo-controlled, cross-over trial. Participants received 12 weeks each of placebo and antioxidant supplementation (vitamins A, C and E, selenium, methionine and ubiquinone) in random order, separated by a 4-week washout period. The primary trial outcome (fatigue) was assessed using the Fisk scale. Other symptoms of primary biliary cirrhosis were measured using Likert and visual analogue scales.


RESULTS
Forty-four patients completed both arms of the trial. No significant changes in fatigue were recorded in the active phase of treatment (median improvement in Fisk score, 1; P = 0.61). Small improvements in Fisk scores were recorded during placebo therapy (median improvement, 4; P = 0.03). Neither medication was associated with improvement in any other symptoms related to primary biliary cirrhosis. Adverse effects were more common during active therapy and were mild and self-limiting. One patient died from unrelated causes during active treatment.


CONCLUSIONS
Although oral antioxidant supplementation appears to be safe, we could not find any evidence for a beneficial effect on fatigue or other liver-related symptoms.
Prince
M I
MI
Centre for Liver Research, Newcastle University Medical School, Framlington Place, Newcastle, Tyne & Wear, NE2 4LL, UK. martin.prince@ncl.ac.uk
Mitchison
H C
HC
Ashley
D
D
Burke
D A
DA
Edwards
N
N
Bramble
M G
MG
James
O F W
OF
Jones
D E J
DE
D000284:Administration, Oral; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage; D018592:Cross-Over Studies; D019587:Dietary Supplements; D004311:Double-Blind Method; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications*; D008715:Methionine / Q000008:administration & dosage; D012643:Selenium / Q000008:administration & dosage; D014451:Ubiquinone / Q000008:administration & dosage; D014801:Vitamin A / Q000008:administration & dosage; D014810:Vitamin E / Q000008:administration & dosage
D000975:Antioxidants; D014801:Vitamin A; D014451:Ubiquinone; D014810:Vitamin E; D008715:Methionine; D012643:Selenium; D001205:Ascorbic Acid