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25.04.2022 | Original Article

Randomised clinical trial: effect of adding branched chain amino acids to exercise and standard-of-care on muscle mass in cirrhotic patients with sarcopenia

verfasst von: Srikant Mohta, Abhinav Anand, Sanchit Sharma, Sumaira Qamar, Samagra Agarwal, Deepak Gunjan, Namrata Singh, Kumble Seetarama Madhusudhan, Ravindra Mohan Pandey, Anoop Saraya

Erschienen in: Hepatology International | Ausgabe 3/2022

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Abstract

Background

The role of branched-chain amino acids (BCAA) in improving muscle mass in cirrhosis is presently debatable.

Aims

To evaluate the role of BCAA in improving muscle mass in a double-blind randomized placebo-controlled trial in patients with cirrhosis having sarcopenia.

Methods

Consecutive patients with cirrhosis with Child–Pugh score < 10 and sarcopenia were randomized to receive either 12 g/day of BCAA orally or a placebo (1:1) for 6 months in addition to a home-based exercise program (30 min/day), dietary counselling and standard medical therapy. Sarcopenia was defined according to gender-specific axial skeletal muscle index (SMI) cut-offs. The primary endpoint was a change in muscle mass based on CT scan (SMI) after 6 months of supplementation.

Results

Sixty patients [mean age 41.6 ± 9.9 years; males (66.6%) of predominantly viral (40%) and alcohol-related (31.7%) cirrhosis] were randomized. Baseline clinical and demographic characters were similar except MELD score (10.2 ± 2.8 vs. 12.2 ± 3.5, p = 0.02) and calorie intake (1838.1 kcal ± 631.5 vs. 2217.5 kcal ± 707.3, p = 0.03), both being higher in the placebo arm. After adjusting for both baseline confounders, baseline SMI and protein intake, the change in SMI at 6 months was similar in both groups [mean adjusted difference (MAD) + 0.84, CI − 2.9; + 1.2, p = 0.42] by intention-to-treat analysis. The secondary outcomes including change in handgrip strength (p = 0.65), 6-m gait speed (p = 0.20), 6-min walk distance (p = 0.39) were similar in both arms. Four patients had minor adverse events in each arm.

Conclusion

Addition of BCAA to exercise, dietary counselling and standard medical therapy did not improve muscle mass in patients with cirrhosis having sarcopenia. (CTRI/2019/05/019269).

Trial registration number

CTRI/2019/05/019269 (Clinical Trials Registry of India).

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Titel: Randomised clinical trial: effect of adding branched chain amino acids to exercise and standard-of-care on muscle mass in cirrhotic patients with sarcopenia
verfasst von: Srikant Mohta
Abhinav Anand
Sanchit Sharma
Sumaira Qamar
Samagra Agarwal
Deepak Gunjan
Namrata Singh
Kumble Seetarama Madhusudhan
Ravindra Mohan Pandey
Anoop Saraya
Publikationsdatum: 25.04.2022
Verlag: Springer India
Erschienen in: Hepatology International / Ausgabe 3/2022
Print ISSN: 1936-0533
Elektronische ISSN: 1936-0541
DOI: https://doi.org/10.1007/s12072-022-10334-7

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Abstract

Background

Aims

Methods

Results

Conclusion

Trial registration number

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