Natural supplementation to effectively treat cancer-induced fatigue: evidence of a meta-analysis on the use of guaraná

Abstract

BACKGROUND: Cancer-related fatigue is a pervasive symptom, affecting up to 90% of cancer patients throughout their illness, and can persist well after treatment has ended. Despite its prevalence, no definitive evidence-based treatment exists, leading to an abundance of proposed alternatives, including natural supplements. To further explore the potential effects of guaraná on cancer-related fatigue, a systematic review with meta-analysis was conducted and registered on the International Prospective Register of Systematic Reviews (CRD42023484144). METHODS: A thorough search of PubMed/MEDLINE and Cochrane Library was conducted using MeSH terms and related keywords for cancer-related fatigue and guaraná. Eligible studies were selected according to predetermined criteria and assessed for quality in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Data extraction was independently performed by two reviewers, with any discrepancies resolved by a third researcher. RESULTS: In total, 4 full articles and 1 abstract, encompassing a total of 229 patients from 2009 to 2023, were included in the meta-analysis. Despite high heterogeneity between studies (I2=78%, |2=18.51, df=4, p=0.0010), the analysis revealed a significant benefit of using guaraná to alleviate cancer-related fatigue, with a standard mean difference of -0.77 (95%CI -1.34, -0.21) and a test for the overall effect of Z=2.68 (p=0.007). CONCLUSION: This meta-analysis provides support for the use of guaraná in the treatment of cancer-related fatigue. However, further investigation through larger prospective randomized controlled trials is necessary to validate these findings.