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Acetyl-L-carnitine for the prevention of taxane-induced neuropathy in patients with breast cancer: a systematic review and meta-analysis.

  • 2023-03
  • Research in pharmaceutical sciences 18(2)
    • Mahnaz Momenzadeh
    • Amir Aria
    • Keyvan Ghadimi
    • Azadeh Moghaddas

Study Design

Type
Review
Population
patients with taxane-induced neuropathy (TIN)
Methods
systematic review and meta-analysis of 3 articles, using random-effect model for 12-24 weeks' analysis
Duration
12-24 weeks

Background and purpose

Peripheral neuropathy is one of the most prevalent and undesirable side effects of taxane-containing chemotherapy regimens. This study aimed to investigate the effect of acetyl-L-carnitine (ALC) on the prevention of taxane-induced neuropathy (TIN).

Experimental approach

MEDLINE, PubMed, Cochrane Library, Embase, Web of Science, and Google scholar were systemically applied as electronic databases from 2010 to 2019. The current systematic review was carried out based on the main considerations of PRISMA preferential reporting items for systematic review and meta-analyses. Since there was no significant discrepancy, the random-effect model was used for 12-24 weeks' analysis (I2 = 0%, P = 0.999).

Findings/results

Twelve related titles and abstracts were found during the search, 6 of them were excluded in the first phase. In the second phase, the full text of the remaining 6 articles was comprehensively evaluated and 3 papers were rejected. Finally, 3 articles complied with the inclusion criteria and pooled analyses. The meta-analysis showed a risk ratio of 0.796 (95% CI between 0.486 and 1.303), so, the effects model was used for 12-24 weeks' analysis (I2 = 0%, P = 0.999) since no significant discrepancies were observed. There was no evidence of ALC's positive effect on the prevention of TIN during 12 weeks, and it was revealed that ALC significantly increased TIN in 24 weeks.

Conclusion and implications

According to our findings, the hypothesis that ALC had a positive effect on preventing TIN in 12 weeks has not been proved; however, ALC led to an increase in the TIN in 24 weeks.

Research Insights

Adverse Events Reported

  • Acetyl-Carnitine→peripheral neuropathy

    it was revealed that ALC significantly increased TIN in 24 weeks

    Finding
    Increased risk
    Magnitude
    risk ratio of 0.796 (95% CI between 0.486 and 1.303) for 12-24 weeks; ALC significantly increased TIN in 24 weeks
    Significant
    Yes
  • Acetyl-Carnitine→peripheral neuropathy

    There was no evidence of ALC's positive effect on the prevention of TIN during 12 weeks

    Finding
    No significant difference
    Magnitude
    risk ratio of 0.796 (95% CI between 0.486 and 1.303)
    Significant
    No
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