Clinical and Molecular Hepatology (Jun 2013)

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

DOI
https://doi.org/10.3350/cmh.2013.19.2.165
Journal volume & issue
Vol. 19, no. 2
pp. 165 – 172

Abstract

Read online

Background/AimsCarnitine 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.Methods130 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.ResultsAmong 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 mono-treatment.ConclusionsALT 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.

Keywords