Monfared SSMS, Vahidi H, Abdolghaffari AH, Nikfar S, Abdollahi M. Antioxidant therapy in the management of acute, chronic and post-ERCP pancreatitis: A systematic review. World J Gastroenterol 2009; 15(36): 4481-4490 [PMID: 19777606 DOI: 10.3748/wjg.15.4481]
Corresponding Author of This Article
Mohammad Abdollahi, Professor, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, and Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran 1417614411, Iran. mohammad@tums.ac.ir
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Editorial
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World J Gastroenterol. Sep 28, 2009; 15(36): 4481-4490 Published online Sep 28, 2009. doi: 10.3748/wjg.15.4481
Antioxidant therapy in the management of acute, chronic and post-ERCP pancreatitis: A systematic review
Seyed Sajad Mohseni Salehi Monfared, Hamed Vahidi, Amir Hossein Abdolghaffari, Shekoufeh Nikfar, Mohammad Abdollahi
Seyed Sajad Mohseni Salehi Monfared, Endocrinology and Metabolism Research Centre, Tehran University of Medical Sciences, Tehran 1411413137, Iran
Hamed Vahidi, Student Scientific Research Center, Tehran University of Medical Science, Tehran 1417614411, Iran
Amir Hossein Abdolghaffari, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Shekoufeh Nikfar, Food & Drug Affairs and Food & Drug Laboratory Research Center, Ministry of Health & Medical Education, Tehran 1314715311, Iran
Mohammad Abdollahi, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, and Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Author contributions: Mohseni Salehi Monfared SS reviewed the data and drafted the manuscript; Vahidi H carried out the bibliography and collected the data; Abdolghaffari AH collected the data and prepared tables; Nikfar S conducted the meta-analysis, reviewed the data and the manuscript; Abdollahi M supervised the entire study and edited the manuscript.
Correspondence to: Mohammad Abdollahi, Professor, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, and Endocrinology & Metabolism Research Centre, Tehran University of Medical Sciences, Tehran 1417614411, Iran. mohammad@tums.ac.ir
Telephone: +98-21-66959104 Fax: +98-21-66959104
Received: June 25, 2009 Revised: August 3, 2009 Accepted: August 10, 2009 Published online: September 28, 2009
Abstract
We systematically reviewed the clinical trials which recruited antioxidants in the therapy of pancreatitis and evaluated whether antioxidants improve the outcome of patients with pancreatitis. Electronic bibliographic databases were searched for any studies which investigated the use of antioxidants in the management of acute pancreatitis (AP) or chronic pancreatitis (CP) and in the prevention of post-endoscopic retrograde cholangio-pancreatography (post-ERCP) pancreatitis (PEP) up to February 2009. Twenty-two randomized, placebo-controlled, clinical trials met our criteria and were included in the review. Except for a cocktail of antioxidants which showed improvement in outcomes in three different clinical trials, the results of the administration of other antioxidants in both AP and CP clinical trials were incongruent and heterogeneous. Furthermore, antioxidant therapy including allopurinol and N-acetylcysteine failed to prevent the onset of PEP in almost all trials. In conclusion, the present data do not support a benefit of antioxidant therapy alone or in combination with conventional therapy in the management of AP, CP or PEP. Further double blind, randomized, placebo-controlled clinical trials with large sample size need to be conducted.
