A systematic review and meta-analysis of propionyl-l-carnitine effects on exercise performance in patients with claudication

Vascular Medicine (United Kingdom)

Volumn 18, Issue 1, 2013, Pages 3-12

  Brass, Eric P ^a   Koster, David ^b   Hiatt, William R ^c   Amato, Antonino ^d  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b InStat Services   (United States)

^c UNIVERSITY OF COLORADO SCHOOL OF MEDICINE   (United States)

^d Sigma Tau SpA   (Italy)

Author keywords

cardiovascular diseases; claudication (see intermittent claudication); clinical trials; exercise test; peripheral arterial disease; peripheral vascular diseases; walking

Indexed keywords

PLACEBO; PROPIONYLCARNITINE;

ANKLE BRACHIAL INDEX; ARTICLE; CARDIOVASCULAR SYMPTOM; CLAUDICATION; DEMOGRAPHY; DIABETES MELLITUS; DRUG EFFICACY; DRUG SAFETY; DRUG TOLERABILITY; DRUG WITHDRAWAL; ENERGY EXPENDITURE; EUROPE; EXERCISE; GASTROINTESTINAL SYMPTOM; HUMAN; META ANALYSIS; PHASE 3 CLINICAL TRIAL (TOPIC); PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); RUSSIAN FEDERATION; SINGLE DRUG DOSE; SYSTEMATIC REVIEW; TREADMILL EXERCISE; TREATMENT DURATION; UNITED STATES; UNSPECIFIED SIDE EFFECT; WALKING;

CARNITINE; CLINICAL TRIALS AS TOPIC; EXERCISE TEST; HUMANS; INTERMITTENT CLAUDICATION; WALKING;

EID: 84874456704     PISSN: 1358863X     EISSN: 14770377     Source Type: Journal    
DOI: 10.1177/1358863X12467491     Document Type: Article

References (42)

1. Hiatt WR. Medical treatment of peripheral arterial disease and claudication. N Engl J Med. 2001 ; 344: 1608-1621 (Pubitemid 32479915)
2. Gardner AW, Afaq A. Management of lower extremity peripheral arterial disease. J Cardiopulm Rehabil Prev. 2008 ; 28: 349-357
3. Falcone RA, Hirsch AT, Regensteiner JG, et al. Peripheral arterial disease rehabilitation: A review. J Cardiopulm Rehabil. 2003 ; 23: 170-175 (Pubitemid 36666839)
4. Nylaende M, Abdelnoor M, Stranden E, et al. The Oslo balloon angioplasty versus conservative treatment study (OBACT) - The 2-years results of a single centre, prospective, randomised study in patients with intermittent claudication. Eur J Vasc Endovasc Surg. 2007 ; 33: 3-12 (Pubitemid 44856515)
5. Almahameed A, Bhatt DL. Contemporary management of peripheral arterial disease: III. Endovascular and surgical management. Cleve Clin J Med. 2006 ; 73: S45-51
6. Radack K, Wyderski RJ. Conservative management of intermittent claudication. Ann Intern Med. 1990 ; 113: 135-146 (Pubitemid 20218631)
7. Sorkin EM, Markham A. Cilostazol. Drugs Aging. 1999 ; 14: 63-71 (Pubitemid 29050247)
8. Hiatt WR, Money SR, Brass EP. Long-term safety of cilostazol in patients with peripheral artery disease: The CASTLE study (Cilostazol: A Study in Long-term Effects). J Vasc Surg. 2008 ; 47: 330-336
9. Brass EP, Hiatt WR, Green S. Skeletal muscle metabolic changes in peripheral arterial disease contribute to exercise intolerance: A point-counterpoint discussion. Vasc Med. 2004 ; 9: 293-301 (Pubitemid 40202246)
10. Pipinos II, Judge AR, Selsby JT, et al. The myopathy of peripheral arterial occlusive disease: Part 2. Oxidative stress, neuropathy, and shift in muscle fiber type. Vasc Endovascular Surg. 2008 ; 42: 101-112 (Pubitemid 351559569)
11. Bremer J. Carnitine - metabolism and functions. Physiol Rev. 1983 ; 63: 1420-1480
12. Stephens FB, Constantin-Teodosiu D, Greenhaff PL. New insights concerning the role of carnitine in the regulation of fuel metabolism in skeletal muscle. J Physiol. 2007 ; 581: 431-444 (Pubitemid 46831747)
13. Hiatt WR, Nawaz D, Brass EP. Carnitine metabolism during exercise in patients with peripheral vascular disease. J Appl Physiol. 1987 ; 62: 2383-2387 (Pubitemid 17093454)
14. Hiatt WR, Wolfel EE, Regensteiner JG, Brass EP. Skeletal muscle carnitine metabolism in patients with unilateral peripheral arterial disease. J Appl Physiol. 1992 ; 73: 346-353
15. Di Lisa F, Menabo R, Siliprandi N. L-propionyl-carnitine protection of mitochondria in ischemic rat hearts. Mol Cell Biochem. 1989 ; 88: 169-173 (Pubitemid 19203213)
16. Malaguarnera M, Gargante MP, Russo C, et al. L-carnitine supplementation to diet: A new tool in treatment of nonalcoholic steatohepatitis - A randomized and controlled clinical trial. Am J Gastroenterol. 2010 ; 105: 1338-1345
17. Shakeri A, Tabibi H, Hedayati M. Effects of l-carnitine supplement on serum inflammatory cytokines, C-reactive protein, lipoprotein (a), and oxidative stress in hemodialysis patients with Lp (a) hyperlipoproteinemia. Hemodial Int. 2010 ; 14: 498-504
18. Brass EP, Scarrow AM, Ruff LJ, Masterson KA, Van Lunteren E. Carnitine delays rat skeletal muscle fatigue in vitro. J Appl Physiol. 1993 ; 75: 1595-1600 (Pubitemid 23318205)
19. Dutta A, Ray K, Singh VK, Vats P, Singh SN, Singh SB. L-carnitine supplementation attenuates intermittent hypoxia-induced oxidative stress and delays muscle fatigue in rats. Exp Physiol. 2008 ; 93: 1139-1146
20. Brevetti G, Diehm C, Lambert D. European multicenter study on propionyl-L-carnitine in intermittent claudication. J Am Coll Cardiol. 1999 ; 34: 1618-1624 (Pubitemid 29528679)
21. Hiatt WR, Regensteiner JG, Creager MA, et al. Propionyl-L-carnitine improves exercise performance and functional status in patients with claudication. Am J Med. 2001 ; 110: 616-622 (Pubitemid 32510688)
22. Hiatt WR, Creager MA, Amato A, Brass EP. Effect of propionyl-L-carnitine on a background of monitored exercise in patients with claudication secondary to peripheral artery disease. J Cardiopulm Rehabil Prev. 2011 ; 31: 125-132
23. Margaria R. Sulla fisiologia e specialmente sul consumo energetico della Marcia e della corsa verie velocità ed inclinazioni del terreno. Atti Accad Naz Lincei (Roma). 1938 ; 7: 299-368
24. Marconi C, Ferretti G, Anchisi S, et al. Energetics of walking in patients with peripheral arterial disease: A proposed functional evaluation protocol. Clin Sci (Lond). 2003 ; 105: 105-111 (Pubitemid 36819583)
25. Mantel N. Chi-square test with one degree of freedom: Extension of the Mantel-Haenszel procedure. J Am Stat Assoc. 1963 ; 58: 690-700
26. Lehmann E Non Parametrics: Statistical Methods Based on Ranks. San Francisco: Holden-Day ; 1975 :
27. Boissel JP, Blanchard J, Panak E, Peyrieux JC, Sacks H. Considerations for the meta-analysis of randomized clinical trials. Summary of a panel discussion. Control Clin Trials. 1989 ; 10: 254-281 (Pubitemid 20014084)
28. Goa KL, Brogden RN. l-Carnitine. A preliminary review of its pharmacokinetics, and its therapeutic use in ischaemic cardiac disease and primary and secondary carnitine deficiencies in relationship to its role in fatty acid metabolism. Drugs. 1987 ; 34: 1-24 (Pubitemid 17092320)
29. Girolami B, Bernardi E, Prins MH, et al. Treatment of intermittent claudication with physical training, smoking cessation, pentoxifylline, or nafronyl: A meta-analysis. Arch Intern Med. 1999 ; 159: 337-345 (Pubitemid 29091621)
30. Pande RL, Hiatt WR, Zhang P, Hittel N, Creager MA, McDermott M. A pooled analysis of the durability and predictors of treatment response of cilostazol in patients with intermittent claudication. Vasc Med. 2010 ; 15: 181-188
31. Watson L, Ellis B, Leng GC. Exercise for intermittent claudication. Cochrane Database Syst Rev. 2008 ;: CD000990
32. Regensteiner JG, Ware JE, McCarthy WJ, et al. Effect of cilostazol on treadmill walking, community-based walking ability, and health-related quality of life in patients with intermittent claudication due to peripheral arterial disease: Meta-analysis of six randomized controlled trials. J Am Geriatr Soc. 2002 ; 50: 1939-1946 (Pubitemid 35462438)
33. Evans AM, Fornasini G. Pharmacokinetics of L-carnitine. Clin Pharmacokinet. 2003 ; 42: 941-967 (Pubitemid 37056103)
34. Cao Y, Wang YX, Liu CJ, Wang LX, Han ZW, Wang CB. Comparison of pharmacokinetics of L-carnitine, acetyl-L-carnitine and propionyl-L-carnitine after single oral administration of L-carnitine in healthy volunteers. Clin Invest Med. 2009 ; 32: E13-19
35. Brass EP, Hoppel CL, Hiatt WR. Effect of intravenous L-carnitine on carnitine homeostasis and fuel metabolism during exercise in humans. Clin Pharmacol Ther. 1994 ; 55: 681-692 (Pubitemid 24212269)
36. Brevetti G, Perna S, Sabba C, et al. Superiority of L-propionylcarnitine vs L-carnitine in improving walking capacity in patients with peripheral vascular disease: An acute, intravenous, double-blind, cross-over study. Eur Heart J. 1992 ; 13: 251-255
37. Brevetti G, Chiariello M, Ferulano G, et al. Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: A double-blind, cross-over study. Circulation. 1988 ; 77: 767-773 (Pubitemid 18093497)
38. Stephens FB, Constantin-Teodosiu D, Laithwaite D, Simpson EJ, Greenhaff PL. A threshold exists for the stimulatory effect of insulin on plasma L-carnitine clearance in humans. Am J Physiol Endocrinol Metab. 2007 ; 292: E637-641 (Pubitemid 46220590)
39. Wiseman LR, Brogden RN. Propionyl-L-carnitine. Drugs Aging. 1998 ; 12: 243-248 (Pubitemid 28130098)
40. Greco AV, Mingrone G, Bianchi M, Ghirlanda G. Effect of propionyl-L-carnitine in the treatment of diabetic angiopathy: Controlled double blind trial versus placebo. Drugs Exp Clin Res. 1992 ; 18: 69-80
41. Brevetti G, Perna S, Sabba C, Martone VD, Condorelli M. Propionyl-L-carnitine in intermittent claudication: Double-blind, placebo-controlled, dose titration, multicenter study. J Am Coll Cardiol. 1995 ; 26: 1411-1416
42. Strano A. Propionyl-L-carnitine versus pentoxifylline: Improvement in walking capacity in patients with intermittent claudication. Clin Drug Invest. 2002 ; 22: 1-6 (Pubitemid 34293257)