Ann Hepatol. 2013 Sep-Oct;12(5):803-9.
Oral acetyl-L-carnitine treatment in hepatic encephalopathy: view of evidence-based medicine.
Jiang Q1,
Jiang G,
Shi KQ,
Cai H,
Wang YX,
Zheng MH.
Author information
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.
