Effect of antioxidant therapy on hospital stay and complications in patients with early acute pancreatitis: a randomised controlled trial.
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.
Sateesh
Javvaji
J
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi-110029, India.
Bhardwaj
Payal
P
Singh
Namrata
N
Saraya
Anoop
A
D000111:Acetylcysteine / Q000627:therapeutic use*; D000208:Acute Disease; D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D018384:Oxidative Stress; D010195:Pancreatitis / Q000150:complications / Q000188:drug therapy*; D010865:Pilot Projects; D010919:Placebos; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000975:Antioxidants; D015415:Biomarkers; D010919:Placebos; D001205:Ascorbic Acid; D000111:Acetylcysteine