The Effectiveness of Carnitine in Reducing Cancer-Related Fatigue in Adults:A Systematic Review

Abstract

Cancer-related fatigue is a complex, multifactorial, multidimensional condition affecting 70-80% of cancer patients. Despite the high prevalence of the condition, there is still no standard pharmacologic intervention to date. Up to one-third of patients suffering from cancer-related fatigue are not well-managed with detrimental consequences to their performance status, functionality, and quality of life.This systematic review aims determine the effectiveness of carnitine in reducing fatigue symptoms, as well as, improving the performance status and quality of life of adult patients diagnosed with cancer. We searched for and retrieved randomized controlledtrials involving adult cancer patients with fatigue symptoms who were given either carnitine or placebo. After searching theCochrane Database, MedLine, PubMed, EMBASE and unpublished studies of ClinicalTrials.gov, and then conducting a manual review of cross-referenced articles, seven trials were included in this systematic review. Cochrane protocol was employed in assessing the risk of bias and Revman Software version 5.3 was used for the analysis. Majority of the studies showed no significant improvement in fatigue scores. Only the studies that utilized a combination arm showed improvement in their fatigue symptoms. But due to the presence of other substance in these studies, the treatment effect of carnitine itself remains inconclusive.The trials that measured performance status and quality of life have inconsistent results. There was a trend towards improvement in the quality of life, but the effect of carnitine was not statistically significant.Review of currentclinical data shows that there is no significant difference between carnitine and placebo in reducing fatigue, improving performance status, and quality of life. Atpresent, carnitine still has no proven role in the armamentarium against cancer-related fatigue.