Effect of L-carnitine on quality of life in covert hepatic encephalopathy: a randomized, double-blind, placebo-controlled study
- Author:
Eileen L. YOON
1
;
Sang Bong AHN
;
Dae Won JUN
;
Yong Kyun CHO
;
Do Seon SONG
;
Jae Yoon JEONG
;
Hee Yeon KIM
;
Young Kul JUNG
;
Myeong Jun SONG
;
Sung Eun KIM
;
Hyoung Su KIM
;
Soung Won JEONG
;
Sang Gyune KIM
;
Tae Hee LEE
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2022;37(4):757-767
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:L-carnitine is potentially beneficial in patients with hepatic encephalopathy (HE). We aimed to evaluate the impact of L-carnitine on the quality of life and liver function in patients with liver cirrhosis and covert HE.
Methods:We conducted an investigator-initiated, prospective, multi-center, double- blind, randomized phase III trial in patients with covert HE. A total of 150 patients were randomized 1:1 to L-carnitine (2 g/day) or placebo for 24 weeks. Changes in quality of life and liver function were assessed at 6 months. The model for end-stage liver disease (MELD), the 36-Item Short Form Survey (SF-36), the psychometric hepatic encephalopathy score (PHES), and the Stroop Test were evaluated in all patients.
Results:The total SF-36 score significantly improved in the L-carnitine group after 24 weeks (difference: median, 2; interquartile range, 0 to 11; p < 0.001); however, these values were comparable between the two groups. Furthermore, there was a significant ordinal improvement in PHES scores among patients with minimal HE who were in the L-carnitine group (p = 0.007). Changes in the total carnitine level also positively correlated with improvements in the Stroop test in the L-carnitine group (color test, r = 0.3; word test, r = 0.4; inhibition test, r = 0.5; inhibition/switching test, r = 0.3; all p < 0.05). Nevertheless, the MELD scores at week 24 did not differ between the groups.
Conclusions:Twenty-four weeks of L-carnitine supplementation was safe but ineffective in improving quality of life and liver function.
