Background
There is no effective medical therapy for chronic pancreatitis (CP) and micronutrient antioxidant therapy has been proposed to reduce oxidative stress at the acinar level. Although the large ANTICIPATE trial showed no benefit from antioxidant therapy, the study only examined treatment for 6 months. Longer-term treatment may be required to modulate chronic disease and this study looks at long-term outcome in patients with CP treated with antioxidant therapy.

Materials and Methods
Case notes of patients with CP treated during the 8 years to 1st January 1998 were identified from hospital final diagnosis codes (ICD 10 K86.1 and K86.0). Eighteen patients (10 [55%] male) with CP were treated with micronutrient antioxidant therapy.

Result
The most common aetiology was alcohol (12 [66%]). Median (range) follow-up in months was 66(12-120). At presentation 13(72%) had abdominal pain and at last follow-up 8 (44%) reported pain (P= 0.18; Fisher’s exact). At presentation 1 (6%) was on insulin compared to 4(22%) at last follow-up (P=0.34; [Fisher’s]). Eight (44%) were on opiates at baseline and 6(33%) (P=0.73; [Fisher’s]) at the end.

Conclusion
Although a small cohort, this is the first report of the long-term use of micronutrient antioxidant therapy in CP. There appear to be no treatment-related complications from long-term use. Accepting risk of type II error, there appears to be no effect of therapy on the natural history of the disease with no effect on relief of pain or preservation of islet function.