Efficacy and effectiveness of carnitine supplementation for cancer-related fatigue: A systematic literature review and meta-analysis

Wolfgang Marx, Laisa Teleni, Rachelle S. Opie, Jaimon T Kelly, Skye Marshall, Catherine Itsiopoulos, Elisabeth Isenring

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Abstract

Background
Carnitine deficiency has been implicated as a potential pathway for cancer-related fatigue that could be treated with carnitine supplementation. The aim of this systematic literature review and meta-analysis was to evaluate the literature regarding the use of supplemental carnitine as a treatment for cancer-related fatigue. 
Methods
Using the PRISMA guidelines, an electronic search of the Cochrane Library, MEDLINE, Embase, CINAHL and reference lists was conducted. Data were extracted and independently assessed for quality using the Academy of Nutrition and Dietetics evidence analysis by two reviewers. In studies with positive quality ratings, a meta-analysis was performed using the random-effects model on Carnitine and cancer-related fatigue. 
Results
Twelve studies were included for review with eight reporting improvement in measures of fatigue, while four reported no benefit. However, many studies were non-randomized, open-label and/or used inappropriate dose or comparators. Meta-analysis was performed in three studies with sufficient data. Carnitine did not significantly reduce cancer-related fatigue with a standardized mean difference (SMD) of 0.06 points ((95% CI −0.09, 0.21); p = 0.45). 
Conclusion 
Results from studies with lower risk of bias do not support the use of carnitine supplementation for cancer-related fatigue.
Original languageEnglish
Article number1224
Number of pages24
JournalNutrients
Volume9
Issue number11
DOIs
Publication statusPublished - 7 Nov 2017

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Carnitine
carnitine
meta-analysis
Fatigue
Meta-Analysis
neoplasms
Neoplasms
dietetics
Dietetics
Second Primary Neoplasms
electronics
MEDLINE
Libraries
nutrition
Guidelines
dosage

Cite this

Marx, Wolfgang ; Teleni, Laisa ; Opie, Rachelle S. ; Kelly, Jaimon T ; Marshall, Skye ; Itsiopoulos, Catherine ; Isenring, Elisabeth. / Efficacy and effectiveness of carnitine supplementation for cancer-related fatigue : A systematic literature review and meta-analysis. In: Nutrients. 2017 ; Vol. 9, No. 11.
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abstract = "BackgroundCarnitine deficiency has been implicated as a potential pathway for cancer-related fatigue that could be treated with carnitine supplementation. The aim of this systematic literature review and meta-analysis was to evaluate the literature regarding the use of supplemental carnitine as a treatment for cancer-related fatigue. MethodsUsing the PRISMA guidelines, an electronic search of the Cochrane Library, MEDLINE, Embase, CINAHL and reference lists was conducted. Data were extracted and independently assessed for quality using the Academy of Nutrition and Dietetics evidence analysis by two reviewers. In studies with positive quality ratings, a meta-analysis was performed using the random-effects model on Carnitine and cancer-related fatigue. ResultsTwelve studies were included for review with eight reporting improvement in measures of fatigue, while four reported no benefit. However, many studies were non-randomized, open-label and/or used inappropriate dose or comparators. Meta-analysis was performed in three studies with sufficient data. Carnitine did not significantly reduce cancer-related fatigue with a standardized mean difference (SMD) of 0.06 points ((95{\%} CI −0.09, 0.21); p = 0.45). Conclusion Results from studies with lower risk of bias do not support the use of carnitine supplementation for cancer-related fatigue.",
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Efficacy and effectiveness of carnitine supplementation for cancer-related fatigue : A systematic literature review and meta-analysis. / Marx, Wolfgang; Teleni, Laisa; Opie, Rachelle S.; Kelly, Jaimon T; Marshall, Skye; Itsiopoulos, Catherine; Isenring, Elisabeth.

In: Nutrients, Vol. 9, No. 11, 1224, 07.11.2017.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Efficacy and effectiveness of carnitine supplementation for cancer-related fatigue

T2 - A systematic literature review and meta-analysis

AU - Marx, Wolfgang

AU - Teleni, Laisa

AU - Opie, Rachelle S.

AU - Kelly, Jaimon T

AU - Marshall, Skye

AU - Itsiopoulos, Catherine

AU - Isenring, Elisabeth

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N2 - BackgroundCarnitine deficiency has been implicated as a potential pathway for cancer-related fatigue that could be treated with carnitine supplementation. The aim of this systematic literature review and meta-analysis was to evaluate the literature regarding the use of supplemental carnitine as a treatment for cancer-related fatigue. MethodsUsing the PRISMA guidelines, an electronic search of the Cochrane Library, MEDLINE, Embase, CINAHL and reference lists was conducted. Data were extracted and independently assessed for quality using the Academy of Nutrition and Dietetics evidence analysis by two reviewers. In studies with positive quality ratings, a meta-analysis was performed using the random-effects model on Carnitine and cancer-related fatigue. ResultsTwelve studies were included for review with eight reporting improvement in measures of fatigue, while four reported no benefit. However, many studies were non-randomized, open-label and/or used inappropriate dose or comparators. Meta-analysis was performed in three studies with sufficient data. Carnitine did not significantly reduce cancer-related fatigue with a standardized mean difference (SMD) of 0.06 points ((95% CI −0.09, 0.21); p = 0.45). Conclusion Results from studies with lower risk of bias do not support the use of carnitine supplementation for cancer-related fatigue.

AB - BackgroundCarnitine deficiency has been implicated as a potential pathway for cancer-related fatigue that could be treated with carnitine supplementation. The aim of this systematic literature review and meta-analysis was to evaluate the literature regarding the use of supplemental carnitine as a treatment for cancer-related fatigue. MethodsUsing the PRISMA guidelines, an electronic search of the Cochrane Library, MEDLINE, Embase, CINAHL and reference lists was conducted. Data were extracted and independently assessed for quality using the Academy of Nutrition and Dietetics evidence analysis by two reviewers. In studies with positive quality ratings, a meta-analysis was performed using the random-effects model on Carnitine and cancer-related fatigue. ResultsTwelve studies were included for review with eight reporting improvement in measures of fatigue, while four reported no benefit. However, many studies were non-randomized, open-label and/or used inappropriate dose or comparators. Meta-analysis was performed in three studies with sufficient data. Carnitine did not significantly reduce cancer-related fatigue with a standardized mean difference (SMD) of 0.06 points ((95% CI −0.09, 0.21); p = 0.45). Conclusion Results from studies with lower risk of bias do not support the use of carnitine supplementation for cancer-related fatigue.

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