Carnitine or dimethyl sulfoxide, or both, for the treatment of anthracycline extravasation in rats

Abstract

This study aimed to compare the efficacy of topical dimethyl sulfoxide (DMSO), intralesional and systemic carnitine as monotherapy and in combination against ulceration in rats induced by intradermal doxorubicin extravasation. Sixty-nine 3-month-old male Wistar albino rats, weighing between 200-225 g, were used in this study. Rats were applied monotherapy or a combination of topical DMSO, intraperitoneal or intralesional carnitine. Control groups received saline or no drug. The necrotic area was measured and extravasated neutrophil leukocytes were counted in healthy tissue adjacent to necrotic areas. Monotherapy with topical and systemic carnitine did not significantly reduce the size of necrotic areas. However, topical DMSO had reduced necrotic areas and inflammatory cells significantly and the addition of systemic carnitine to topical DMSO had increased the efficacy. DMSO is an effective, safe, and easy-to-apply treatment for doxorubicin-induced extravasation. Further clinical studies are needed to evaluate the use of carnitine in combination with DMSO.

Re: Goutos et al. Extravasation injuries: a review. J Hand Surg Eur. 2014, 39: 808–18

“…The majority of the literature on the agent comprises case studies with only three controlled studies reporting encouraging results in association with anthracycline-related injuries (Lebredo et al, 1992;Svingen et al, 1981;Uzunoglu et al, 2013). Interestingly, there is a well conducted murine study questioning the effect of DMSO in doxorubicin extravasations (Dorr and Alberts, 1983), as well as two reporting toxicity issues following its administration (Creus et al, 2002;Llinares et al, 2005).…”