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Review
. 2023 Jan 19;18(2):112-120.
doi: 10.4103/1735-5362.367791. eCollection 2023 Apr.

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

Mahnaz Momenzadeh  1 , Amir Aria  2 , Keyvan Ghadimi  3 , Azadeh Moghaddas  1
Affiliations
Review

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

Mahnaz Momenzadeh et al. Res Pharm Sci. .

Abstract

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.

Keywords: Acetyl-L-carnitine; Breast cancer; Chemotherapy; Neuropathy; Taxane.

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Conflict of interest statement

The authors declared no conflict of interest in this study.

Figures

Fig. 1
Fig. 1
Flow chart describing the search and selection of studies according to the PRISMA guidelines.
Fig. 2
Fig. 2
Forest plot of acetyl-L-carnitine effects on the prevention of taxane-induced neuropathy. Heterogeneity: chi-squared (χ2) test = 0.00 (degree of freedom = 2), P = 0.999, I2 test (variation in RR attributable to heterogeneity) = 0.0%, test of RR = 1, z = 0.91, P = 0.363. RR, Risk ratio.
See this image and copyright information in PMC

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