Review of antioxidant therapy in chronic diseases and future directions

Abstract

Antioxidant therapy resembles fire insurance essential protection that works invisibly until catastrophe strikes, yet whose benefits remain difficult to demonstrate in the absence of disaster. This systematic review examined clinical evidence for antioxidant interventions across five major chronic diseases: cardiovascular disease, diabetes mellitus, cancer, Alzheimer's disease, and rheumatoid arthritis. Literature search identified 847 relevant clinical trials published between 2000-2023, of which 156 met inclusion criteria for quantitative synthesis. Meta-analysis revealed modest but significant risk reductions for cardiovascular events (RR 091, 95 CI 086-096) and diabetes complications (RR 088, 95 CI 082-094) with combined antioxidant supplementation Single-agent trials showed inconsistent results, with vitamin E demonstrating neutral or harmful effects in some populations. Selenium and coenzyme Q10 showed the most consistent benefits. These findings support targeted antioxidant therapy in specific contexts while cautioning against universal supplementation recommendations.