Systematic review: the treatment of muscle cramps in patients with cirrhosis

Vidot, Helen; Carey, Sharon; Allman‐Farinelli, Margaret; Shackel, Nicholas

doi:10.1111/apt.12827

Cited by 48 publications

(33 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Endogenous carnitine is mainly synthesized in the liver, making cirrhotic patients more susceptible to carnitine deficiency (7). Several reports have described the usefulness of l-carnitine supplementation in cases of cirrhosis, with confirmed effectiveness against refractory hepatic encephalopathy and cramps (8,9); however, the relationship between carnitine supplementation and intervention for HCC remains unknown. Furthermore, changes in blood levels of carnitine after invasive treatments for HCC have not been evaluated.…”

mentioning

confidence: 99%

Usefulness of Levocarnitine and/or Branched-Chain Amino Acids during Invasive Treatment for Hepatocellular Carcinoma

Iwasa

Sugimoto

Ishihara

et al. 2015

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

View full text Add to dashboard Cite

Summary Transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective treatments for hepatocellular carcinoma (HCC). However, the extent of treatment depends on hepatic functional reserve. l-Carnitine is a vitamin-like substance and several reports have described the usefulness of l-carnitine supplementation in cases of cirrhosis, with confirmed effectiveness against refractory hepatic encephalopathy. On the other hand, we have previously reported that in patients who underwent TACE or RFA, administration of branched-chain amino acids (BCAAs) pre-intervention significantly reduced inflammatory reactions. We first determined serum levels of total, free, and acyl-carnitine before and at 7 d after performing TACE in 10 HCC patients. We administered levocarnitine (l-carnitine chloride, a biologically active form of carnitine) at 900 mg/d to 69 consecutive HCC patients hospitalized to undergo TACE and/or RFA, and compared changes in blood test values with those in 119 consecutive patients not administered this drug. Sixty-seven patients had a history of using BCAAs at the time of admission. We found that after 7 d of TACE, serum levels of total and acyl-carnitine are significantly decreased. On comparing the four groups, the carnitine1BCAA, carnitine-alone, and BCAA-alone groups showed significantly higher values for changes in NH3 when compared with the non-dosed group. The decrease in albumin (Alb) was significantly suppressed in the carnitine1BCAA and BCAAalone groups. We also conducted the same examinations in a subset of patients classified as Child-Pugh class A, and noted the same trends. Administration of levocarnitine and/ or BCAAs during invasive treatments reduced blood NH3 concentrations and suppressed decreases in Alb.

show abstract

mentioning

confidence: 99%

Usefulness of Levocarnitine and/or Branched-Chain Amino Acids during Invasive Treatment for Hepatocellular Carcinoma

Iwasa

Sugimoto

Ishihara

et al. 2015

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

View full text Add to dashboard Cite

show abstract

“…As mentioned above, several investigators reported that L-carnitine reduced serum ammonia levels, leading to an improvement in hepatic encephalopathy, and ameliorated LC-related neurological findings and LC-related clinical symptoms such as muscle cramps [13, 14, 23]. Moreover, several recent studies demonstrated that L-carnitine supplementation contributed to normalization of liver enzymes and an improvement in cytopenia during treatment for patients with chronic hepatitis B or C infection [24, 25].…”

Section: Discussionmentioning

confidence: 99%

Effect of L-Carnitine in Patients With Liver Cirrhosis on Energy Metabolism Using Indirect Calorimetry: A Pilot Study

et al. 2016

View full text Add to dashboard Cite

Background: L-carnitine supplementation has been suggested to show several favorable effects on patients with liver cirrhosis (LC). However, there have been no reports regarding the effect of L-carnitine on energy metabolism in patients with LC using indirect calorimetry which is a well-established method for assessing the degree of liver malnutrition. We examined the effect of L-carnitine in patients with LC on energy metabolism using indirect calorimetry.

show abstract

“…Many agents showed positive results in muscle cramps treatment in cirrhotic patients, but there is still need of controlled trials. The most interesting agents are taurine, whose synthesis is reduced in cirrhosis leading to a decrease in membrane stabilization, and quinine sulfate[122]. Baclofen is also used by some physicians due to its skeletal-muscle relaxant activity.…”

Section: Best Supportive Carementioning

confidence: 99%

Challenges of advanced hepatocellular carcinoma

Colagrande

Inghilesi

Aburas

et al. 2016

WJG

146

115

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is an aggressive malignancy, resulting as the third cause of death by cancer each year. The management of patients with HCC is complex, as both the tumour stage and any underlying liver disease must be considered conjointly. Although surveillance by imaging, clinical and biochemical parameters is routinely performed, a lot of patients suffering from cirrhosis have an advanced stage HCC at the first diagnosis. Advanced stage HCC includes heterogeneous groups of patients with different clinical condition and radiological features and sorafenib is the only approved treatment according to Barcelona Clinic Liver Cancer. Since the introduction of sorafenib in clinical practice, several phase III clinical trials have failed to demonstrate any superiority over sorafenib in the frontline setting. Loco-regional therapies have also been tested as first line treatment, but their role in advanced HCC is still matter of debate. No single agent or combination therapies have been shown to impact outcomes after sorafenib failure. Therefore this review will focus on the range of experimental therapeutics for patients with advanced HCC and highlights the successes and failures of these treatments as well as areas for future development. Specifics such as dose limiting toxicity and safety profile in patients with liver dysfunction related to the underlying chronic liver disease should be considered when developing therapies in HCC. Finally, robust validated and reproducible surrogate end-points as well as predictive biomarkers should be defined in future randomized trials.

show abstract

Systematic review: the treatment of muscle cramps in patients with cirrhosis

Cited by 48 publications

References 45 publications

Usefulness of Levocarnitine and/or Branched-Chain Amino Acids during Invasive Treatment for Hepatocellular Carcinoma

Usefulness of Levocarnitine and/or Branched-Chain Amino Acids during Invasive Treatment for Hepatocellular Carcinoma

Effect of L-Carnitine in Patients With Liver Cirrhosis on Energy Metabolism Using Indirect Calorimetry: A Pilot Study

Challenges of advanced hepatocellular carcinoma

Contact Info

Product

Resources

About