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A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy.

Abstract

OBJECTIVE

To evaluate the effects and safety of 300-600 mg α-lipoic acid (ALA) given i.v. for diabetic peripheral neuropathy (DPN).

METHODS

We searched the databases of Medline, Embase, and Cochrane central register of Controlled Trials and Chinese biological medicine for clinical trials of ALA in the treatment of DPN. Data were extracted to examine methodological quality and describe characteristics of studies. The primary outcomes were efficacy, median motor nerve conduction velocity (MNCV), median sensory nerve conduction velocity (SNCV), peroneal MNCV, and peroneal SNCV. Secondary outcomes were adverse events.

RESULTS

Fifteen randomized controlled trials met the inclusion criteria. The treatment group involved the administration of ALA 300-600 mg i.v. per day. And the control group used the same interventions except for ALA. Compared with the control group, nerve conduction velocities increased significantly in the treatment group. The weighted mean differences in nerve conduction velocities were 4.63 (95% confidence interval 3.58-5.67) for median MNCV, 3.17 (1.75-4.59) for median SNCV, 4.25 (2.78-5.72) for peroneal MNCV, and 3.65 (1.50-5.80) for peroneal SNCV in favor of the treatment group. The odds ratio in terms of efficacy was 4.03 (2.73-5.94) for ALA. Furthermore, no serious adverse events were observed during the treatment period.

CONCLUSIONS

The results of this meta-analysis provide evidence that treatment with ALA (300-600 mg/day i.v. for 2-4 weeks) is safe and that the treatment can significantly improve both nerve conduction velocity and positive neuropathic symptoms. However, the evidence may not be strong because most of the studies included in this meta-analysis have poor methodological quality.

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  • Authors+Show Affiliations

    ,

    Department of Endocrinology, Renji Hospital, Shanghai Jiaotong University, 200127 Shanghai, China.

    , ,

    Source

    European journal of endocrinology 167:4 2012 Oct pg 465-71

    MeSH

    Adult
    Aged
    Antioxidants
    Asian Continental Ancestry Group
    Diabetic Neuropathies
    Humans
    Middle Aged
    Randomized Controlled Trials as Topic
    Thioctic Acid
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    22837391

    Citation

    Han, Tingting, et al. "A Systematic Review and Meta-analysis of Α-lipoic Acid in the Treatment of Diabetic Peripheral Neuropathy." European Journal of Endocrinology, vol. 167, no. 4, 2012, pp. 465-71.
    Han T, Bai J, Liu W, et al. A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol. 2012;167(4):465-71.
    Han, T., Bai, J., Liu, W., & Hu, Y. (2012). A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy. European Journal of Endocrinology, 167(4), pp. 465-71. doi:10.1530/EJE-12-0555.
    Han T, et al. A Systematic Review and Meta-analysis of Α-lipoic Acid in the Treatment of Diabetic Peripheral Neuropathy. Eur J Endocrinol. 2012;167(4):465-71. PubMed PMID: 22837391.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy. AU - Han,Tingting, AU - Bai,Jiefei, AU - Liu,Wei, AU - Hu,Yaomin, Y1 - 2012/07/25/ PY - 2012/7/28/entrez PY - 2012/7/28/pubmed PY - 2012/12/10/medline SP - 465 EP - 71 JF - European journal of endocrinology JO - Eur. J. Endocrinol. VL - 167 IS - 4 N2 - OBJECTIVE: To evaluate the effects and safety of 300-600 mg α-lipoic acid (ALA) given i.v. for diabetic peripheral neuropathy (DPN). METHODS: We searched the databases of Medline, Embase, and Cochrane central register of Controlled Trials and Chinese biological medicine for clinical trials of ALA in the treatment of DPN. Data were extracted to examine methodological quality and describe characteristics of studies. The primary outcomes were efficacy, median motor nerve conduction velocity (MNCV), median sensory nerve conduction velocity (SNCV), peroneal MNCV, and peroneal SNCV. Secondary outcomes were adverse events. RESULTS: Fifteen randomized controlled trials met the inclusion criteria. The treatment group involved the administration of ALA 300-600 mg i.v. per day. And the control group used the same interventions except for ALA. Compared with the control group, nerve conduction velocities increased significantly in the treatment group. The weighted mean differences in nerve conduction velocities were 4.63 (95% confidence interval 3.58-5.67) for median MNCV, 3.17 (1.75-4.59) for median SNCV, 4.25 (2.78-5.72) for peroneal MNCV, and 3.65 (1.50-5.80) for peroneal SNCV in favor of the treatment group. The odds ratio in terms of efficacy was 4.03 (2.73-5.94) for ALA. Furthermore, no serious adverse events were observed during the treatment period. CONCLUSIONS: The results of this meta-analysis provide evidence that treatment with ALA (300-600 mg/day i.v. for 2-4 weeks) is safe and that the treatment can significantly improve both nerve conduction velocity and positive neuropathic symptoms. However, the evidence may not be strong because most of the studies included in this meta-analysis have poor methodological quality. SN - 1479-683X UR - https://www.unboundmedicine.com/medline/citation/22837391/full_citation L2 - https://eje.bioscientifica.com/doi/10.1530/EJE-12-0555 DB - PRIME DP - Unbound Medicine ER -