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Vitamin E for the Prevention of Chemotherapy-Induced Peripheral Neuropathy: A meta-Analysis
Front Pharmacol
2021 May 13;12:684550.
doi: 10.3389/fphar.2021.684550
Author
Jie Chen , Haili Shan , Wenjun Yang , Jiali Zhang , Haibin Dai , Ziqi Ye
Author Information
1Department of Pharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
2Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Edited by: Robert Clarke, University of Minnesota Twin Cities, United States
Reviewed by: David Balayssac, Université Clermont Auvergne, France
Ganesh Prasad Mishra, Swami Vivekanand Subharti University, India
✉Correspondence: Haibin Dai, haibindai@zju.edu.cn; Ziqi Ye, ziqiye@zju.edu.cn
This article was submitted to Pharmacology of Anti-Cancer Drugs, a section of the journal Frontiers in Pharmacology
Article notes
Copyright and License information
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
PMC Copyright notice
PMCID: PMC8155355 PMID: 34054560
Abstract
Background
Vitamin E has been increasingly used to prevent chemotherapy-induced peripheral neuropathy (CIPN) in recent years. However, it is still unclear whether vitamin E can effectively prevent CIPN.
Methods
We searched all clinical studies in the Embase, Cochrane Library, Clinicaltrials.gov, and PubMed databases from inception to December 2020. We performed a meta-analysis of 9 randomized controlled trials (RCTs) with 486 patients that compared the vitamin E group with the control group. Outcomes of the study were incidence of all-grade CIPN, incidence of severe CIPN, and the total neuropathy scores (TNS). Random effect models were used to make the meta-analysis results more cautious.
Results
Notably, vitamin E significantly reduced the incidence of all-grade CIPN (overall risk ratio (RR) = 0.55, 95% CI: 0.36, 0.85, I2 = 77.3%, p = 0.007), and TNS (overall standard mean difference (SMD) = −0.64, 95% CI: −1.03, −0.25, I2 = 42.7%, p = 0.001). However, the results of the subgroup analysis, which included only double-blind RCTs, suggested that vitamin E did not significantly reduce the incidence of all-grade CIPN (overall RR = 0.52, 95% CI: 0.07, 4.06, I2 = 77.5%, p = 0.531). Moreover, there was no significant difference in the incidence of severe CIPN between these two arms (p = 0.440).
Conclusion
The results of our meta-analysis suggests that vitamin E has a beneficial effect on the incidence and symptoms of CIPN. However, routine prophylactic use of vitamin E is still not recommended. Moreover, more high-quality double-blind RCTs are needed to further validate the effects of vitamin E in prevention of CIPN.
Keywords:
vitamin E, CIPN, incidence of all-grade peripheral neuropathy, total neuropathy scores, meta-analysis