Publication: Comparative study among glutamine, acetyl-L-carnitine, vitamin-E and methylcobalamine for treatment of paclitaxel-induced peripheral neuropathy
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| Title | Comparative study among glutamine, acetyl-L-carnitine, vitamin-E and methylcobalamine for treatment of paclitaxel-induced peripheral neuropathy |
| Topic | Vitamin E, Carnitine, Vitamin B12 |
| Author | Mondal, S, Choudhury, KB, Sharma, S, Gupta, A, Dutta, S |
| Year | 2014 |
| Journal | Clinical Cancer Investigation Journal |
| DOI | https://doi.org/10.4103/2278-0513.132113 |
Author's Abstract The abstract and the information and conclusions contained therein were written by the authors of the publication.
| Context
One of the major toxicities of paclitaxel is peripheral neuropathy, primarily affecting sensory components more than motor and autonomic functions. Acetyl-L-carnitine (ALC), methylcobalamine, vitamin E, and glutamine have been tested in various trials against placebos. This randomized study was conducted to compare the efficacy of these four drugs in relieving symptoms of paclitaxel-induced peripheral neuropathy. Settings and Design This single-institution, prospective, multi-arm, randomized study was conducted per the Helsinki protocol with local ethical committee clearances. Materials and Methods Patients with carcinomas of the lung, breast, and ovary were recruited to receive paclitaxel 175 mg/m² intravenously as a 1st or 2nd line drug. They were randomized into one of four treatment arms: Arm A (vitamin E 400 mg OD from day 1 of the cycle to 1 month after completion of clinical trial [CT]); Arm B (ALC 250 mg OD from day 1 to day 7 in each cycle of CT); Arm C (glutamine 10 mg TDS from day 2 to day 5 in each cycle); and Arm D (methylcobalamine 500 μg TDS from day 1 of the first cycle to 1 month after completion of CT). All drugs were started at the onset of symptoms. CTCAE v 4.02 was used for assessments. Statistical Analysis Used Changes in scores for sensory, motor, and pain symptoms over the study period were compared using repeated measures of the General Linear Model of SPSS version 17. Results A total of 22, 24, 21, and 23 patients were eligible for analysis in the four arms. Vitamin E produced comparable relief to methylcobalamine in alleviating peripheral neuropathy. Both vitamin E and methylcobalamine were superior to glutamine and ALC in relieving sensory, motor, and pain symptoms. Glutamine and ALC had comparable effects. Conclusions All four drugs were effective in alleviating symptoms, with vitamin E and methylcobalamine being more effective than glutamine and ALC in controlling symptoms of paclitaxel-induced peripheral neuropathy. |
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