GS06
A randomized, multi-center, double-blinded, placebo controlled,
investigator-initiated trial to assess the impact of L-carnitine
administration on the quality of life in the liver cirrhosis with
covert hepatic encephalopathy
Eileen Yoon1, Dae Won Jun2, Sang Bong Ahn3, Yong Kyun Cho4,
Do Seon Song5, Jaeyoon Jeong6, Hee Yeon Kim7, Young Kul Jung8,
Myeong Jun Song9, Hyoung Su Kim10, Sung Eun Kim11,
Soung Won Jeong12, Sang Gyune Kim13, Tae Hee Lee14,
Hokyoung Ryu15. 1Sanggye Paik Hospital, Inje University College of
Medicine, Internal Medicine, Seoul, Korea, Rep. of South; 2Hanyang
University Hospital, Internal Medicine, Seoul, Korea, Rep. of South;
3Nowon Eulji Medical Center, Eulji University College of Medicine,
Internal Medicine, Seoul, Korea, Rep. of South; 4Kangbuk Samsung
Hospital, Sungkyunkwan University School of Medicine, Internal
Medicine, Seoul, Korea, Rep. of South; 5St. Vincent’s Hospital, College of
Medicine, The Catholic University of Korea, Internal Medicine, Suwon-si,Korea, Rep. of South; 6National Medical Center, Internal Medicine, Seoul,
Korea, Rep. of South; 7Uijeongbu St. Mary’s Hospital, The Catholic
University, Internal Medicine, Euijeongbu, Korea, Rep. of South; 8Korea
University Ansan Hospital, Korea University College of Medicine, Internal
Medicine, Ansan-si, Korea, Rep. of South; 9Daejeon St. Mary’s Hospital,
College of Medicine, The Catholic University of Korea, Internal Medicine,
Daejeon; 10Kangdong Sacred Heart Hospital, Hallym University College
of Medicine, Internal Medicine, Seoul; 11Hallym University Sacred Heart
Hospital, Hallym University College of Medicine, Internal Medicine,
Anyang-si, Korea, Rep. of South; 12Soonchunhyang University College of
Medicine, Soonchunhyang University Seoul Hospital, Internal Medicine,
Seoul, Korea, Rep. of South; 13Soonchunhyang University College of
Medicine, Soonchunhyang University Bucheon Hospital, Bucheon-si,
Korea, Rep. of South; 14Konyang University College of Medicine, Internal
Medicine, Daejeon; 15Hanyang University, Arts & Technology, Seoul,
Korea, Rep. of South
Email: [email protected]
Background and Aims: Covert hepatic encephalopathy (CHE) leads
to poor quality of life (QOL) in liver cirrhosis (LC) patients.We aimed
to evaluate the impact of L-carnitine on the QOL evaluated by the 36-
Item Short Form Survey (SF-36) in CHE patients following 24weeks of
treatment. Secondary endpointswere the effects of L-carnitine on the
improvement of cognitive dysfunction.
Method: We performed a prospective, randomized, double-blinded,
placebo-controlled study administering L-carnitine for 24 weeks to
LC patients with CHE. Thirteen centers fromKoreawere engaged. CHE
was defined as either West-Haven grade 1 or grade 0 with the
Psychometric hepatic encephalopathy score (PHES) below −4.
Patients who had previously experienced overt HE were excluded.
Results: A total of 230 LC patients were screened. 150 CHE patients
underwent randomization. The mean agewas 53 years and 65% were
male. Mostly they were chronic hepatitis B and 82% were Child-Pugh
A. Seventy two and 70 patients were randomly assigned to the
placebo group and the L-carnitine group. Baseline characteristics
including results of PHES scores were similar between the groups.
Although SF-36 levels were not different between the groups, the
differences of SF-36 between the baseline and at 24 weeks of
treatment were 2.42 ± 12.86 in the placebo vs. 4.60 ± 11.73 in the Lcarnitine
groups (P = 0.001). Trend analysis for PHES showed
significant improvement in the L-carnitine group (P = 0.023). The
rate correct score of inhibition test among the Korean Stroop Test at
24 weeks of treatment was significantly higher in the L-carnitine
group (P = 0.038). Additionally, the gap of total carnitine level
between the baseline and week 24 were positively correlated with
the improvement of rate correct scores of all four components in the
Korean Stroop Test (r = 0.3 for Color Test; r = 0.4 forWord Test; r = 0.5
for Inhibition Test; r = 0.3 for Inhibition/Switching Test; all P values
<0.05) in the L-carnitine group.
Conclusion: Administration of L-carnitine for 24 weeks in the LC
patients with CHE were related to improvement of QOL as well as
cognitive function.作者: StephenW 时间: 2020-8-23 12:11