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Efficacy and safety of entecavir plus carnitine complex (GODEX?) compared to entecavir monotherapy in patient with ALT elevated chronic hepatitis B: randomized, multicenter open-label trials. The GOAL study.

 Dae Won Jun  ;  Byung Ik Kim  ;  Yong Kyun Cho  ;  Hong Ju Kim  ;  Young Oh Kwon  ;  Soo Young Park  ;  Sang Young Han  ;  Yang Hyun Baek  ;  Yong Jin Jung  ;  Hwi Young Kim  ;  Won Kim  ;  Jeong Heo  ;  Hyun Young Woo  ;  Seong Gyu Hwang  ;  Kyu Sung Rim  ;  Jong Young Choi  ;  Si Hyun Bae  ;  Young Sang Lee  ;  Young Suck Lim  ;  Jae Youn Cheong  ;  Sung Won Cho  ;  Byung Seok Lee  ;  Seok Hyun Kim  ;  Joo Hyun Sohn  ;  Tae Yeob Kim  ;  Yong Han Paik  ;  Ja Kyung Kim  ;  Kwan Sik Lee 
 CLINICAL AND MOLECULAR HEPATOLOGY, Vol.19(2) : 165-172, 2013 
Journal Title
Issue Date
Adult ; Alanine Transaminase/blood ; Antiviral Agents/therapeutic use* ; Carnitine/therapeutic use* ; DNA, Viral/analysis ; Drug Therapy, Combination ; Enzyme-Linked Immunospot Assay ; Female ; Guanine/analogs & derivatives* ; Guanine/therapeutic use ; Hepatitis B Surface Antigens/blood ; Hepatitis B e Antigens/blood ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/drug therapy* ; Humans ; Interferon-gamma/metabolism ; Male ; Middle Aged ; Mitochondria/physiology ; Treatment Outcome ; Vitamin B Complex/therapeutic use*
Carnitine ; Entecavir ; Hepatitis B
Background/Aims: Carnitine and vitamin complex (GodexⓇ) is widely used in patients with chronic liver disease who show elevated liver enzyme in South Korea. The purpose of this study is to identify the efficacy and safety of carnitine from entecavir combination therapy in Alanine aminotransferase (ALT) elevated Chronic Hepatitis B (CHB) patients.
Methods: 130 treatment-naïve patients with CHB were enrolled from 13 sites. The patients were randomly selected to the entecavir and the complex of entecavir and carnitine. The primary endpoint of the study is ALT normalization level after 12 months.
Results: Among the 130 patients, 119 patients completed the study treatment. The ALT normalization at 3 months was 58.9% for the monotherapy and 95.2% for the combination therapy (P<0.0001). ALT normalization rate at 12 months was 85.7% for the monotherapy and 100% for the combination group (P=0.0019). The rate of less than HBV DNA 300 copies/mL at 12 months was not statistically significant (P=0.5318) 75.9% for the monotherapy, 70.7% for the combination and it was. Quantification of HBsAg level was not different from the monotherapy to combination at 12 months. Changes of ELISPOT value to evaluate the INF-γ secretion by HBsAg showed the increasing trend of combination therapy compare to monotreatment.
Conclusions: ALT normalization rate was higher in carnitine complex combination group than entecavir group in CHB. Combination group was faster than entecavir mono-treatment group on ALT normalization rate. HBV DNA normalization rate and the serum HBV-DNA level were not changed by carnitine complex treatment.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ja Kyung(김자경) ORCID logo https://orcid.org/0000-0001-5025-6846
Paik, Yong Han(백용한)
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
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