Antioxidant Therapies in the Treatment of Aminoglycoside-Induced Ototoxicity: A Meta-Analysis

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Patrick J Gaffney1, Kunal R Shetty1, Sancak Yuksel1

  • 1Department of Otorhinolaryngology - Head and Neck Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA.

The Laryngoscope
|November 12, 2024
PubMed
Abstract

Insights

N-acetylcysteine (NAC) and aspirin show promise in preventing aminoglycoside-induced ototoxicity. While effective in reducing hearing damage, more high-quality clinical trials are needed to confirm long-term benefits and explore other antioxidants.

Area of Science:

  • Ototoxicity research
  • Antioxidant therapies
  • Clinical trial analysis

Background:

  • Aminoglycoside treatment can cause ototoxicity, potentially due to reactive oxygen species.
  • Animal studies suggest antioxidants may prevent this, but human clinical data is limited.
  • This review focuses on antioxidant efficacy in preventing aminoglycoside-induced ototoxicity.

Purpose of the Study:

  • To systematically review and meta-analyze the effectiveness of antioxidant therapies in preventing aminoglycoside-induced ototoxicity in humans.
  • To evaluate clinical evidence for antioxidants like N-acetylcysteine, aspirin, and vitamin E.

Main Methods:

  • Systematic literature search of PubMed, Embase, Web of Science, and ClinicalTrials.gov conducted in August 2024.
  • Inclusion of randomized controlled trials (RCTs) examining otologic outcomes in humans.
  • Meta-analysis of data from seven included studies.

Main Results:

  • Seven studies met inclusion criteria, investigating N-acetylcysteine (NAC), aspirin, and vitamin E.
  • Pooled analysis indicated NAC (RR 0.112) and aspirin (RR 0.229) significantly reduced ototoxicity.
  • Vitamin E did not show a significant reduction in ototoxicity compared to placebo (RR 0.841).

Conclusions:

  • N-acetylcysteine (NAC) and aspirin demonstrate effectiveness in mitigating aminoglycoside-induced ototoxicity.
  • Current evidence lacks high-quality data, necessitating further research.
  • Future studies should assess long-term benefits and investigate other promising antioxidants.
Keywords:
aminoglycosidesantioxidanthearing lossototoxicity

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