title: Long-term outcome of patients with chronic pancreatitis treated with micronutrient antioxidant therapy.
abstract: BACKGROUND
  Micronutrient antioxidant therapy did not relieve pain in a European randomized trial of patients with chronic pancreatitis without malnutrition. However, intervention was undertaken only for 6 months leaving unanswered the question of whether long-term antioxidant therapy may modulate chronic pancreatitis. The aim of this study is to assess the outcome of long-term use of micronutrient antioxidant therapy in patients with chronic pancreatitis.
  
  
  METHODS
  This is a single center clinical cohort report of patients with chronic pancreatitis prescribed micronutrient antioxidant therapy and followed for up to 10 years. Data were collected on demographic detail, clinic pain assessment, insulin requirements, interventions and outcome.
  
  
  RESULTS
  A group of 30 patients with a diagnosis of chronic pancreatitis constitute the study population. Median age at time of diagnosis was 40 years (range 14-66); 19 (63%) were male and the median duration of symptoms was 2 years (range 0-18). Alcohol was the dominant cause in 22 (73%) patients and 16 (53%) patients were Cambridge stage 1. Twenty-four (80%) patients had pain at presentation. During antioxidant treatment of 4 years (range 1-10), pain decreased but the proportion with abdominal pain compared to those who were pain-free remained constant (P=0.16; two-way ANOVA with Bonferroni correction). There was a significant increase in requirement for insulin (P=0.028) with time together with use of both endoscopic and surgical interventions.
  
  
  CONCLUSIONS
  This is the first study to report long-term disease-specific outcome in patients with chronic pancreatitis prescribed micronutrient antioxidant therapy. There appears to be no effect of intervention on outcome.
authors.affiliation: Hepatobiliary Surgery Unit, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. ajith.siriwardena@cmft.nhs.uk.
authors.forename: Sukitha Namal
authors.initials: SN
authors.lastname: Rupasinghe
authors.forename: Ajith K
authors.initials: AK
authors.lastname: Siriwardena
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000975:Antioxidants / Q000008:administration & dosage* / Q000009:adverse effects; D019587:Dietary Supplements / Q000009:adverse effects; D004739:England; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D050500:Pancreatitis, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000975:Antioxidants; D007004:Hypoglycemic Agents; D007328:Insulin