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Meta-analysis of methylcobalamin alone and in combination with lipoic acid in patients with diabetic peripheral neuropathy.

Abstract

AIMS

To compare the efficacy and safety of daily lipoic acid (300-600 mg i.v.) plus methylcobalamin (500-1000 mg i.v. or im.) (LA-MC) with that of methylcobalamin alone (MC) on diabetic peripheral neuropathy (DPN).

METHODS

Electronic database were searched for studies published up to November 1, 2012 and study quality was assessed in duplicate. A random or a fixed effect model was used to analyse outcomes which were expressed as risk ratios (RRs) or mean difference (MD). I(2) statistic was used to assess heterogeneity.

RESULTS

Seventeen studies were included. Combined data from all studies showed that the LA-MC combination therapy was significantly superior to MC monotherapy (RR=1.47; 95% CI: 1.37-1.58). Superiority of the LA-MC combination was shown in nerve conduction velocity (NCV) with WMDs of 6.89 (95% CI: 4.24-9.73) for median motor nerve conduction velocity (MNCV), 5.24 (4.14-6.34) for median sensory nerve conduction velocity (SNCV), 4.34 (3.03-5.64) for peroneal MNCV, and 4.53 (3.2-5.85) for peroneal SNCV. There were no serious adverse events associated with treatment.

CONCLUSIONS

The results of the meta-analysis show that treatment with LA-MC for 2-4 weeks is associated with better outcomes in NCV and neuropathic symptoms relative to MC treatment. However larger well-designed studies are required to confirm this conclusion.

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  • Authors+Show Affiliations

    ,

    Department of Pharmacy, Zhu-Jiang Hospital, Southern Medical University, Guangzhou, China. xiaoqian7666@163.com

    , , , , , , , ,

    Source

    MeSH

    Diabetic Neuropathies
    Drug Therapy, Combination
    Humans
    Peripheral Nervous System Diseases
    Thioctic Acid
    Vitamin B 12

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review

    Language

    eng

    PubMed ID

    23664235

    Citation

    Xu, Qian, et al. "Meta-analysis of Methylcobalamin Alone and in Combination With Lipoic Acid in Patients With Diabetic Peripheral Neuropathy." Diabetes Research and Clinical Practice, vol. 101, no. 2, 2013, pp. 99-105.
    Xu Q, Pan J, Yu J, et al. Meta-analysis of methylcobalamin alone and in combination with lipoic acid in patients with diabetic peripheral neuropathy. Diabetes Res Clin Pract. 2013;101(2):99-105.
    Xu, Q., Pan, J., Yu, J., Liu, X., Liu, L., Zuo, X., ... Ji, A. (2013). Meta-analysis of methylcobalamin alone and in combination with lipoic acid in patients with diabetic peripheral neuropathy. Diabetes Research and Clinical Practice, 101(2), pp. 99-105. doi:10.1016/j.diabres.2013.03.033.
    Xu Q, et al. Meta-analysis of Methylcobalamin Alone and in Combination With Lipoic Acid in Patients With Diabetic Peripheral Neuropathy. Diabetes Res Clin Pract. 2013;101(2):99-105. PubMed PMID: 23664235.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Meta-analysis of methylcobalamin alone and in combination with lipoic acid in patients with diabetic peripheral neuropathy. AU - Xu,Qian, AU - Pan,Jianhong, AU - Yu,Jingwen, AU - Liu,Xiaoxia, AU - Liu,Li, AU - Zuo,Xialin, AU - Wu,Ping, AU - Deng,Houliang, AU - Zhang,Jingjing, AU - Ji,Aimin, Y1 - 2013/05/09/ PY - 2012/11/19/received PY - 2013/02/12/revised PY - 2013/03/25/accepted PY - 2013/5/14/entrez PY - 2013/5/15/pubmed PY - 2014/3/1/medline KW - Combination therapy KW - Diabetic peripheral neuropathy KW - Lipoic acid KW - Meta-analysis KW - Methylcobalamin SP - 99 EP - 105 JF - Diabetes research and clinical practice JO - Diabetes Res. Clin. Pract. VL - 101 IS - 2 N2 - AIMS: To compare the efficacy and safety of daily lipoic acid (300-600 mg i.v.) plus methylcobalamin (500-1000 mg i.v. or im.) (LA-MC) with that of methylcobalamin alone (MC) on diabetic peripheral neuropathy (DPN). METHODS: Electronic database were searched for studies published up to November 1, 2012 and study quality was assessed in duplicate. A random or a fixed effect model was used to analyse outcomes which were expressed as risk ratios (RRs) or mean difference (MD). I(2) statistic was used to assess heterogeneity. RESULTS: Seventeen studies were included. Combined data from all studies showed that the LA-MC combination therapy was significantly superior to MC monotherapy (RR=1.47; 95% CI: 1.37-1.58). Superiority of the LA-MC combination was shown in nerve conduction velocity (NCV) with WMDs of 6.89 (95% CI: 4.24-9.73) for median motor nerve conduction velocity (MNCV), 5.24 (4.14-6.34) for median sensory nerve conduction velocity (SNCV), 4.34 (3.03-5.64) for peroneal MNCV, and 4.53 (3.2-5.85) for peroneal SNCV. There were no serious adverse events associated with treatment. CONCLUSIONS: The results of the meta-analysis show that treatment with LA-MC for 2-4 weeks is associated with better outcomes in NCV and neuropathic symptoms relative to MC treatment. However larger well-designed studies are required to confirm this conclusion. SN - 1872-8227 UR - https://www.unboundmedicine.com/medline/citation/23664235/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(13)00132-0 DB - PRIME DP - Unbound Medicine ER -