Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection

Background/Aims L-carnitine not only alleviates hyperammonemia and reduces muscle cramps in patients with liver cirrhosis, but also improves anemia in patients with chronic hepatitis and renal dysfunction. This study prospectively evaluated the preventative efficacy of L-carnitine supplementation ag...

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Main Authors: Shinya Sato, Kei Moriya, Masanori Furukawa, Soichiro Saikawa, Tadashi Namisaki, Mitsuteru Kitade, Hideto Kawaratani, Kosuke Kaji, Hiroaki Takaya, Naotaka Shimozato, Yasuhiko Sawada, Kenichiro Seki, Koh Kitagawa, Takemi Akahane, Akira Mitoro, Yasushi Okura, Junichi Yamao, Hitoshi Yoshiji
Format: Article
Language:English
Published: Korean Association for the Study of the Liver 2019-03-01
Series:Clinical and Molecular Hepatology
Subjects:
Online Access:http://e-cmh.org/upload/pdf/cmh-2018-0070.pdf
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author Shinya Sato
Kei Moriya
Masanori Furukawa
Soichiro Saikawa
Tadashi Namisaki
Mitsuteru Kitade
Hideto Kawaratani
Kosuke Kaji
Hiroaki Takaya
Naotaka Shimozato
Yasuhiko Sawada
Kenichiro Seki
Koh Kitagawa
Takemi Akahane
Akira Mitoro
Yasushi Okura
Junichi Yamao
Hitoshi Yoshiji
spellingShingle Shinya Sato
Kei Moriya
Masanori Furukawa
Soichiro Saikawa
Tadashi Namisaki
Mitsuteru Kitade
Hideto Kawaratani
Kosuke Kaji
Hiroaki Takaya
Naotaka Shimozato
Yasuhiko Sawada
Kenichiro Seki
Koh Kitagawa
Takemi Akahane
Akira Mitoro
Yasushi Okura
Junichi Yamao
Hitoshi Yoshiji
Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection
Clinical and Molecular Hepatology
L-carnitine
Hemolytic anemia
Ribavirin
Chronic hepatitis C
Drug therapy
author_facet Shinya Sato
Kei Moriya
Masanori Furukawa
Soichiro Saikawa
Tadashi Namisaki
Mitsuteru Kitade
Hideto Kawaratani
Kosuke Kaji
Hiroaki Takaya
Naotaka Shimozato
Yasuhiko Sawada
Kenichiro Seki
Koh Kitagawa
Takemi Akahane
Akira Mitoro
Yasushi Okura
Junichi Yamao
Hitoshi Yoshiji
author_sort Shinya Sato
title Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection
title_short Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection
title_full Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection
title_fullStr Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection
title_full_unstemmed Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infection
title_sort efficacy of l-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis c virus infection
publisher Korean Association for the Study of the Liver
series Clinical and Molecular Hepatology
issn 2287-2728
2287-285X
publishDate 2019-03-01
description Background/Aims L-carnitine not only alleviates hyperammonemia and reduces muscle cramps in patients with liver cirrhosis, but also improves anemia in patients with chronic hepatitis and renal dysfunction. This study prospectively evaluated the preventative efficacy of L-carnitine supplementation against hemolytic anemia during antiviral treatment using ribavirin in patients with hepatitis C virus (HCV)-related chronic liver disease. Methods A total of 41 patients with chronic hepatitis were consecutively enrolled in this study. Group A (n=22) received sofosbuvir plus ribavirin for 3 months, whereas group B (n=19) was treated with sofosbuvir, ribavirin, and L-carnitine. Hemoglobin concentration changes, the effects of antiviral treatment, and the health status of patients were analyzed using short form-8 questionnaires. Results A significantly smaller decrease in hemoglobin concentration was observed in group B compared to group A at every time point. Moreover, the prescribed dose intensity of ribavirin in group B was higher than that of group A, resulting in a higher ratio of sustained virological response (SVR) 24 in group B compared with group A. The physical function of patients in group B was also significantly improved compared to group A at the end of antiviral treatment. Conclusions L-carnitine supplementation alleviates ribavirin-induced hemolytic anemia in patients with HCV and helps relieve the physical burden of treatment with ribavirin-containing regimens. These advantages significantly increase the likelihood of achieving SVR.
topic L-carnitine
Hemolytic anemia
Ribavirin
Chronic hepatitis C
Drug therapy
url http://e-cmh.org/upload/pdf/cmh-2018-0070.pdf
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spelling doaj-3dd2c12fc0c8465794635f688cc6d5af2020-11-25T02:45:51ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2019-03-01251657310.3350/cmh.2018.00701450Efficacy of L-carnitine on ribavirin-induced hemolytic anemia in patients with hepatitis C virus infectionShinya Sato0Kei Moriya1Masanori Furukawa2Soichiro Saikawa3Tadashi Namisaki4Mitsuteru Kitade5Hideto Kawaratani6Kosuke Kaji7Hiroaki Takaya8Naotaka Shimozato9Yasuhiko Sawada10Kenichiro Seki11Koh Kitagawa12Takemi Akahane13Akira Mitoro14Yasushi Okura15Junichi Yamao16Hitoshi Yoshiji17 Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, Japan Department of Endoscopy, Nara Medical University, Nara, Japan Department of Endoscopy, Nara Medical University, Nara, Japan Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Nara, JapanBackground/Aims L-carnitine not only alleviates hyperammonemia and reduces muscle cramps in patients with liver cirrhosis, but also improves anemia in patients with chronic hepatitis and renal dysfunction. This study prospectively evaluated the preventative efficacy of L-carnitine supplementation against hemolytic anemia during antiviral treatment using ribavirin in patients with hepatitis C virus (HCV)-related chronic liver disease. Methods A total of 41 patients with chronic hepatitis were consecutively enrolled in this study. Group A (n=22) received sofosbuvir plus ribavirin for 3 months, whereas group B (n=19) was treated with sofosbuvir, ribavirin, and L-carnitine. Hemoglobin concentration changes, the effects of antiviral treatment, and the health status of patients were analyzed using short form-8 questionnaires. Results A significantly smaller decrease in hemoglobin concentration was observed in group B compared to group A at every time point. Moreover, the prescribed dose intensity of ribavirin in group B was higher than that of group A, resulting in a higher ratio of sustained virological response (SVR) 24 in group B compared with group A. The physical function of patients in group B was also significantly improved compared to group A at the end of antiviral treatment. Conclusions L-carnitine supplementation alleviates ribavirin-induced hemolytic anemia in patients with HCV and helps relieve the physical burden of treatment with ribavirin-containing regimens. These advantages significantly increase the likelihood of achieving SVR.http://e-cmh.org/upload/pdf/cmh-2018-0070.pdfL-carnitineHemolytic anemiaRibavirinChronic hepatitis CDrug therapy