Evaluation of the cardioprotective effect of l-carnitine and silymarin in cancer patients receiving anthracycline-containing chemotherapy

Zalat, Zeinab Al Kasaby; Elewa, Hosny; Abdel-Latif, Mohamed; El-Din, Mohamed A. Alm; Kohaf, Neeven A.

doi:10.21608/jbaar.2020.119755

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…All trials concluded that levocarnitine has a cardioprotective effect. Four trials studied levocarnitine as a single agent 40–43 and one studied levocarnitine in combination with coenzyme Q (Table 1). 44 One systematic review was obtained 45 – this review did not draw any conclusions cited as due to insufficient data (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…With the global trend in nutraceuticals and drug repurposing, a re-evaluation of the trials of these agents maybe worthwhile to reduce the cost of the burden of the cancer disease. 36,37,41 There is value in re-evaluating the use of vitamin E and levocarnitine as these are tolerable and safe in addition to their affordability and availability. 85…”

Section: Discussionmentioning

confidence: 99%

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Vitamin E and levocarnitine as prophylaxis against doxorubicin-induced cardio toxicity in the adult cancer patient: A review

Moustafa

Saka

Viljoen

et al. 2022

J Oncol Pharm Pract

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Objective Doxorubicin, a component of the anthracycline group, is a highly effective in the treatment of hematologic and solid malignancies. Because of the cardiotoxic adverse effects, use is limited. Antioxidants may negate this anthracycline-induced cardiotoxicity, although the literature is not conclusive with regards to the cardioprotective benefits of antioxidants. This review assessed and mapped evidence of the efficacy of vitamin E and levocarnitine against doxorubicin-induced cardiotoxicity in adult cancer patients. Data Sources This review was based on the Arksey and O’Malley methodology. Potentially relevant literature in English published between January 1960 and April 2021 was identified through a database search. Oxford Quality Scoring System and AMSTR2 were used to assess the quality of trials and systematic reviews respectively, as well as the risks of potential bias. Data Summary Nineteen of the 10 268 (0.2%) articles from the initial search were included in the final analysis (12 clinical trials and 7 systematic reviews). Vitamin E was included in seven prospective clinical trials. Levocarnitine was included in five clinical trials as an individual agent and a single trial as a combination treatment. No trials could be found investigating the combination of vitamin E and levocarnitine in humans. Conclusions This review found that levocarnitine trials showed some cardioprotective effects but the results from vitamin E trials were controversial and inconclusive. Most of the trials reviewed had some shortcomings. Further investigations are therefore needed to determine the efficacy of vitamin E and levocarnitine in preventing doxorubicin-induced cardiotoxicity in adult cancer patients.

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