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Ann Hepatol. 2013 Sep-Oct;12(5):803-9.

Oral acetyl-L-carnitine treatment in hepatic encephalopathy: view of evidence-based medicine.

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1
Department of Pharmacy, the Second People's Hospital of Sichuan Province & Sichuan Provincial Cancer Hospital & Institute, Chengdu, 610041, China.

Abstract

OBJECTIVE:

To systematically review the effect of acetyl-L-carnitine in patients with hepatic encephalopathy.

MATERIAL AND METHODS:

DESIGN:

systematic review and meta-analysis.

DATA SOURCES:

The Cochrane Library, MEDLINE, EMBASE.com, Science Citation Index, Google search and the China Biological Medicine Database to June 2012.

REVIEW METHODS:

randomized placebo controlled trials of acetyl-L-carnitine in patients with hepatic encephalopathy assessing whether acetyl-L-carnitine is an effective therapy or not. No language restrictions were applied. Two reviewers independently extracted data and assessed quality.

RESULTS:

7 methodologically sound randomized controlled trials were identified involving 660 participants with hepatic encephalopathy, totaling 249 with subclinical hepatic encephalopathy, 189 with West Haven grade 1, 162 with West Haven grade 2 and 60 with West Haven grade 3. Acetyl-L-carnitine was effective to improve serum ammonia level (weighted mean difference 25.90, 95% confidence intervals 20.89 to 30.91, P < 0.05) and the number connection test completion time (weighted mean difference 16.62, 95% confidence intervals 9.88 to 23.36, P < 0.05). The outcome was consistent in subgroup analyses. No publication bias was detected. Adverse events were reported infrequently and were minor.

CONCLUSIONS:

Acetyl-L-carnitine is promising as an effective and tolerable treatment for hepatic encephalopathy that associated with improved serum ammonia levels and the number connection test.

PMID:
24018499
[Indexed for MEDLINE]
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