Vol.6 No.4 – 1: Evaluation of the cardioprotective effect of l-carnitine and silymarin in cancer patients receiving anthracycline-containing chemotherapy
By: Zeinab Al kasaby Zalat* 1, Hosny A. Elewa2,Mohamed Abdel-Latif3 , Mohamed A. Alm El-Din4, Neeven A. Kohaf 5
- Assoc. Professor and Head of Clinical Pharmacy Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. (Pharm.D., Ph.D.) (zeinabalkasaby.pharmg@azhar.edu.eg)
- Assoc. professor and Head of Pharmacy Practice Department, Faculty of Pharmacy, Horus University, Dominate City, Egypt. (Pharm.D, Ph.D.)
- Professor and Head of Clinical Pharmacy Department, Faculty of Pharmacy, Assiut University, Assiut, Egypt. (Ph.D.)
- Assoc. Professor, Department of Clinical Oncology, Faculty of Medicine, Tanta University, Tanta, Egypt. (MD)
- Master degree in pharmaceutical sciences, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. (M.Sc.)
Abstract
Aim: Anthracycline-induced cardiotoxicity is the most common constraint of its use in the treatment of various types of cancer. This study aimed to investigate the benefits of the addition of the l-carnitine / silymarin to anthracycline chemotherapy in patients with breast cancer. Methods: 83 patients were recruited from Clinical Oncology Department, Tanta University, Egypt, then prospectively randomized to receive their anthracycline-containing therapeutic regimen, control group (n=33), or anthracycline plus l-carnitine, l-carnitine group (n=25), or anthracycline plus silymarin, silymarin group (n= 25). Blood samples were collected at the beginning and after 6 months to measure LDH, CK-MB, cTn I, Anticardiolipin IgG, Fe, ferritin, and TIBC and % of saturation. % EF was documented. Data were statistically analyzed by ANOVA and paired t-test. P <0.05 was statistically significant. Results: The addition of l-carnitine to anthracycline chemotherapy has a significantly improved EF% (P=0.003), Anticardiolipin IgG (P=0.001), ferritin (P=0.001), and TIBC (P=0.011). The supplementation with silymarin to anthracycline chemotherapy had a statistically significant decrease in Anticardiolipin IgG (P=0.000), iron (P=0.001), ferritin (P= 0.001), TIBC (P=0.007), and % saturation (P=0.001). Silymarin group showed a significant decrease in iron profile compared to the l-carnitine group. Conclusion: The co-administration of l-carnitine or silymarin with anthracycline chemotherapy represents a new therapeutic strategy for better control of anthracycline-induced cardiotoxicity. Silymarin resulted in more beneficial effects on the iron profile compared to l-carnitine with anthracycline or anthracycline chemotherapy alone.
Evaluation-of-the-cardioprotective-effect-of-l-carnitine-and-silymarin-in-cancer-patients-receiving-anthracycline-containing-chemotherapy-converted
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