title: Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.
abstract: BACKGROUND
  Hand-foot syndrome (HFS) is a relatively frequent dermatologic toxic reaction to certain anti-cancer chemotherapies. The syndrome can evolve into a distressing condition that limits function and affects quality of life. Pyridoxine (vitamin B6) has been used empirically for the prevention of HFS caused by anti-cancer therapy. However, evidence of its efficacy remains controversial.
  Systematic literature searches were conducted on the Cochrane Library, PUBMED, EMBASE, LILACS, CBM, CNKI, VIP, WANFANG and the U.S. ClinicalTrials.gov website. We included all related randomized controlled trials (RCTs) irrespective of language. Reviewers from different professions independently assessed all potential studies and extracted data. Subgroup analysis was planned according to dose of pyridoxine. 5 RCTs involving 607 patients were contributed to the meta-analysis. No significant differences were found between patients receiving pyridoxine and placebo for prevention of incidence of HFS and grade 2 or worse HFS (relative risk (RR) 0.96, 95%confidence interval (CI) 0.86-1.06; RR0.95, 95%CI 0.73-1.24, respectively). Similarly, no significant improvement in quality of life was detected among patients. However, significant difference was found for prevention of grade 2 or worse HFS with pyridoxine 400 mg daily compared to 200 mg (RR0.55, 95%CI 0.33-0.92).
  
  
  CONCLUSIONS
  There is inadequate evidence to make any recommendation about using pyridoxine for prevention of HFS caused by chemotherapy. However, pyridoxine 400 mg may have some efficacy. Further studies of large sample sizes are needed to evaluate the efficacy and safety of pyridoxine, especially at high dose, in comparison with placebo.
authors: Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
authors: Min
authors: M
authors: Chen
authors: Lingli
authors: L
authors: Zhang
authors: Qian
authors: Q
authors: Wang
authors: Jiantong
authors: J
authors: Shen
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D060831:Hand-Foot Syndrome / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome; D025101:Vitamin B 6 / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D025101:Vitamin B 6
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