Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.

<h4>Background</h4>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...

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Main Authors: Min Chen, Lingli Zhang, Qian Wang, Jiantong Shen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0072245
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author Min Chen
Lingli Zhang
Qian Wang
Jiantong Shen
author_facet Min Chen
Lingli Zhang
Qian Wang
Jiantong Shen
author_sort Min Chen
collection DOAJ
description <h4>Background</h4>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.<h4>Methodology//principal findings</h4>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).<h4>Conclusions/significance</h4>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.
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spelling doaj-art-d14b3e2f460d4f009a20c46de93697702025-08-20T03:29:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0188e7224510.1371/journal.pone.0072245Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.Min ChenLingli ZhangQian WangJiantong Shen<h4>Background</h4>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.<h4>Methodology//principal findings</h4>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).<h4>Conclusions/significance</h4>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.https://doi.org/10.1371/journal.pone.0072245
spellingShingle Min Chen
Lingli Zhang
Qian Wang
Jiantong Shen
Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.
PLoS ONE
title Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.
title_full Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.
title_fullStr Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.
title_full_unstemmed Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.
title_short Pyridoxine for prevention of hand-foot syndrome caused by chemotherapy: a systematic review.
title_sort pyridoxine for prevention of hand foot syndrome caused by chemotherapy a systematic review
url https://doi.org/10.1371/journal.pone.0072245
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AT linglizhang pyridoxineforpreventionofhandfootsyndromecausedbychemotherapyasystematicreview
AT qianwang pyridoxineforpreventionofhandfootsyndromecausedbychemotherapyasystematicreview
AT jiantongshen pyridoxineforpreventionofhandfootsyndromecausedbychemotherapyasystematicreview