Tags

Type your tag names separated by a space and hit enter

Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy.

Abstract

OBJECTIVE

In patients with symptomatic diabetic polyneuropathy, is oral alpha-lipoic acid (ALA) effective in improving neuropathic symptoms compared with placebo?

METHODS

The question was addressed with a structured evidence-based clinical neurologic practice review via videoconferencing between 3 academic institutions. Participants included consultant and resident neurologists, clinical epidemiologists, medical librarians, and clinical content experts. A critically appraised topic format was employed, with a clinical scenario, structured question, search strategy, appraisal, results, summary of evidence, commentary, and bottom-line conclusions.

RESULTS

A single modestly valid randomized controlled trial demonstrated that oral ALA in doses of 600 mg, 1200 mg, and 1800 mg was effective in reducing neuropathic symptoms of diabetic distal symmetric polyneuropathy (DSP) at 5 weeks, as assessed by the Total Symptom Score (>or=50% reduction), with number needed to treat (NNT) (95% CI) of 2.7 (1.8 to 5.8), 4.1 (2.3 to 20.2), and 3.2 (2.0 to 8.6), respectively. Adverse events, including nausea, vomiting, and vertigo, were identified but occurred most frequently with ALA doses of 1200 mg and 1800 mg. Overall, treatment emergent adverse events for ALA 600 mg were not significantly different than placebo, but ALA 1200 mg and 1800 mg had number needed to harm (95% CI) of 4.5 (2.4 to 31.0) and 3.0 (1.9 to 7.1), respectively.

CONCLUSION

Oral ALA may improve neuropathic symptoms in diabetic DSP. A single modestly valid RCT demonstrated that 600 mg was an effective and well-tolerated dose, with NNT 2.7 to significantly reduce neuropathic pain symptoms over a 5-week period. ALA's role and place in an algorithm among other commonly prescribed oral treatments for symptomatic relief of neuropathic pain in diabetic DSP remains unclear.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA.

    , , ,

    Source

    The neurologist 13:3 2007 May pg 164-7

    MeSH

    Administration, Oral
    Aged
    Antioxidants
    Diabetic Nephropathies
    Dose-Response Relationship, Drug
    Double-Blind Method
    Humans
    Male
    Meta-Analysis as Topic
    Severity of Illness Index
    Thioctic Acid

    Pub Type(s)

    Case Reports
    Clinical Trial
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17495764

    Citation

    Tang, Junger, et al. "Alpha-lipoic Acid May Improve Symptomatic Diabetic Polyneuropathy." The Neurologist, vol. 13, no. 3, 2007, pp. 164-7.
    Tang J, Wingerchuk DM, Crum BA, et al. Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy. Neurologist. 2007;13(3):164-7.
    Tang, J., Wingerchuk, D. M., Crum, B. A., Rubin, D. I., & Demaerschalk, B. M. (2007). Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy. The Neurologist, 13(3), pp. 164-7.
    Tang J, et al. Alpha-lipoic Acid May Improve Symptomatic Diabetic Polyneuropathy. Neurologist. 2007;13(3):164-7. PubMed PMID: 17495764.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy. AU - Tang,Junger, AU - Wingerchuk,Dean M, AU - Crum,Brian A, AU - Rubin,Devon I, AU - Demaerschalk,Bart M, PY - 2007/5/15/pubmed PY - 2007/7/19/medline PY - 2007/5/15/entrez SP - 164 EP - 7 JF - The neurologist JO - Neurologist VL - 13 IS - 3 N2 - OBJECTIVE: In patients with symptomatic diabetic polyneuropathy, is oral alpha-lipoic acid (ALA) effective in improving neuropathic symptoms compared with placebo? METHODS: The question was addressed with a structured evidence-based clinical neurologic practice review via videoconferencing between 3 academic institutions. Participants included consultant and resident neurologists, clinical epidemiologists, medical librarians, and clinical content experts. A critically appraised topic format was employed, with a clinical scenario, structured question, search strategy, appraisal, results, summary of evidence, commentary, and bottom-line conclusions. RESULTS: A single modestly valid randomized controlled trial demonstrated that oral ALA in doses of 600 mg, 1200 mg, and 1800 mg was effective in reducing neuropathic symptoms of diabetic distal symmetric polyneuropathy (DSP) at 5 weeks, as assessed by the Total Symptom Score (>or=50% reduction), with number needed to treat (NNT) (95% CI) of 2.7 (1.8 to 5.8), 4.1 (2.3 to 20.2), and 3.2 (2.0 to 8.6), respectively. Adverse events, including nausea, vomiting, and vertigo, were identified but occurred most frequently with ALA doses of 1200 mg and 1800 mg. Overall, treatment emergent adverse events for ALA 600 mg were not significantly different than placebo, but ALA 1200 mg and 1800 mg had number needed to harm (95% CI) of 4.5 (2.4 to 31.0) and 3.0 (1.9 to 7.1), respectively. CONCLUSION: Oral ALA may improve neuropathic symptoms in diabetic DSP. A single modestly valid RCT demonstrated that 600 mg was an effective and well-tolerated dose, with NNT 2.7 to significantly reduce neuropathic pain symptoms over a 5-week period. ALA's role and place in an algorithm among other commonly prescribed oral treatments for symptomatic relief of neuropathic pain in diabetic DSP remains unclear. SN - 1074-7931 UR - https://www.unboundmedicine.com/medline/citation/17495764/Alpha_lipoic_acid_may_improve_symptomatic_diabetic_polyneuropathy_ L2 - http://Insights.ovid.com/pubmed?pmid=17495764 DB - PRIME DP - Unbound Medicine ER -