TY - JOUR
T1 - Treatment of Muscle Cramps in Patients With Cirrhosis of Liver
T2 - A Systematic Review
AU - Kalia, Shivam
AU - Nath, Preetam
AU - Pathak, Mona
AU - Anand, Anil C.
N1 - Funding Information:
This study was not funded by any funding agency.
Publisher Copyright:
© 2021 Indian National Association for Study of the Liver
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Background: Muscle cramps are witnessed in 22–88% of patients with cirrhosis of liver and frequently lead to sleep disturbance with an appalling impact on quality of life. Despite such a high prevalence, there is lack of evidence-based management protocol due to scarcity of trials on treatment options in the literature. This study aimed to review systematically the available therapeutic options for muscle cramps in patients with cirrhosis of liver. Methods: A systematic review of the relevant databases (PubMed, Scopus, Embase, and Web of Science) to identify treatments for muscle cramps in patients with hepatic cirrhosis was performed. Studies meeting the selection criteria were reviewed and assessed for risk of bias and analyzed. Results: Twenty-four publications were identified as eligible for inclusion in this systematic review. Seven randomized controlled trials (RCTs) and 17 prospective studies were included. Taurine, methocarbamol, baclofen, and orphenadrine are relatively safer and effective treatment option for muscle cramps in cirrhosis on the basis of recently conducted RCTs. Moreover, L-carnitine, branched-chain amino acids (BCAAs), pregabalin, zinc, and vitamin D are also safe and showed beneficial effects on muscle cramps. However, studies on vitamin E revealed contradictory results. Conclusion: Taurine, BCAAs, orphenadrine, and baclofen are safe and well-tolerated treatment options for muscle cramps in cirrhosis. However, well-designed randomized controlled clinical trials are the need of the hour to determine the most suitable treatment options for skeletal muscle cramps in patients with cirrhosis of liver.
AB - Background: Muscle cramps are witnessed in 22–88% of patients with cirrhosis of liver and frequently lead to sleep disturbance with an appalling impact on quality of life. Despite such a high prevalence, there is lack of evidence-based management protocol due to scarcity of trials on treatment options in the literature. This study aimed to review systematically the available therapeutic options for muscle cramps in patients with cirrhosis of liver. Methods: A systematic review of the relevant databases (PubMed, Scopus, Embase, and Web of Science) to identify treatments for muscle cramps in patients with hepatic cirrhosis was performed. Studies meeting the selection criteria were reviewed and assessed for risk of bias and analyzed. Results: Twenty-four publications were identified as eligible for inclusion in this systematic review. Seven randomized controlled trials (RCTs) and 17 prospective studies were included. Taurine, methocarbamol, baclofen, and orphenadrine are relatively safer and effective treatment option for muscle cramps in cirrhosis on the basis of recently conducted RCTs. Moreover, L-carnitine, branched-chain amino acids (BCAAs), pregabalin, zinc, and vitamin D are also safe and showed beneficial effects on muscle cramps. However, studies on vitamin E revealed contradictory results. Conclusion: Taurine, BCAAs, orphenadrine, and baclofen are safe and well-tolerated treatment options for muscle cramps in cirrhosis. However, well-designed randomized controlled clinical trials are the need of the hour to determine the most suitable treatment options for skeletal muscle cramps in patients with cirrhosis of liver.
KW - chronic liver disease
KW - cirrhosis
KW - cramp
KW - muscle cramp
UR - http://www.scopus.com/inward/record.url?scp=85120785936&partnerID=8YFLogxK
U2 - 10.1016/j.jceh.2021.10.147
DO - 10.1016/j.jceh.2021.10.147
M3 - Review article
AN - SCOPUS:85120785936
SN - 0973-6883
VL - 12
SP - 980
EP - 992
JO - Journal of Clinical and Experimental Hepatology
JF - Journal of Clinical and Experimental Hepatology
IS - 3
ER -