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Efficacy and safety of prostaglandin E1 plus lipoic acid combination therapy versus monotherapy for patients with diabetic peripheral neuropathy.

Abstract

The aim of this report was to evaluate the efficacy and safety of prostaglandin E1 (PGE1) plus lipoic acid (LA) for the treatment of diabetic peripheral neuropathy (DPN) compared with that of PGE1 or LA monotherapy. Randomized controlled trials (RCT) published up to 3 August 2014 were reviewed. A random or fixed effect model was used to analyze outcomes expressed as risk ratios (RR) or mean difference (MD) with a 95% confidence interval (CI). I(2) statistic was used to assess heterogeneity. Subgroup and sensitivity analyses were performed. The outcomes measured were as follows: clinical efficacy, median motor nerve conduction velocity (MNCV), median sensory nerve conduction velocity (SNCV), peroneal MNCV, peroneal SNCV and adverse effects. Thirty-one RCT with 2676 participants were included. Clinical efficacy of PGE1+LA combination therapy was significantly better than monotherapy (p<0.00001, RR=1.32, 95% CI 1.26 to 1.38). Compared with monotherapy, PGE1+LA combination therapy led to significant improvements in median MNCV (p<0.00001, MD=4.69, 95% CI 3.16 to 6.23), median SNCV (p<0.00001, MD=5.46, 95% CI 4.04 to 6.88), peroneal MNCV (p<0.00001, MD=5.19, 95% CI 3.71 to 6.67) and peroneal SNCV (p<0.00001, MD=5.50, 95% CI 3.30 to 7.70). There were no serious adverse events associated with drug intervention. PGE1+LA combination therapy is superior to PGE1 or LA monotherapy for improvement of neuropathic symptoms and nerve conduction velocities in patients with DPN. These findings should be further validated by larger well-designed and high-quality RCT.

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  • Authors+Show Affiliations

    ,

    Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Industrial Road No. 253, Haizhu District, Guangzhou 510282, China; Cultivation Base for Key Laboratory of Conservation and Utilization of Rare and Economic Species at Southeast Guangxi, Yulin Normal University, Yulin, China; Department of Biopharmaceutical, School of Life Science and Technology, Yulin Normal University, Yulin, China.

    ,

    Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Industrial Road No. 253, Haizhu District, Guangzhou 510282, China.

    ,

    Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Industrial Road No. 253, Haizhu District, Guangzhou 510282, China.

    ,

    Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Industrial Road No. 253, Haizhu District, Guangzhou 510282, China.

    Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Industrial Road No. 253, Haizhu District, Guangzhou 510282, China. Electronic address: yongwh2005@hotmail.com.

    Source

    MeSH

    Adult
    Alprostadil
    Diabetic Neuropathies
    Drug Therapy, Combination
    Female
    Humans
    Male
    Randomized Controlled Trials as Topic
    Thioctic Acid

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    26775115

    Citation

    Jiang, De-Qi, et al. "Efficacy and Safety of Prostaglandin E1 Plus Lipoic Acid Combination Therapy Versus Monotherapy for Patients With Diabetic Peripheral Neuropathy." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 27, 2016, pp. 8-16.
    Jiang DQ, Li MX, Ma YJ, et al. Efficacy and safety of prostaglandin E1 plus lipoic acid combination therapy versus monotherapy for patients with diabetic peripheral neuropathy. J Clin Neurosci. 2016;27:8-16.
    Jiang, D. Q., Li, M. X., Ma, Y. J., Wang, Y., & Wang, Y. (2016). Efficacy and safety of prostaglandin E1 plus lipoic acid combination therapy versus monotherapy for patients with diabetic peripheral neuropathy. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 27, pp. 8-16. doi:10.1016/j.jocn.2015.07.028.
    Jiang DQ, et al. Efficacy and Safety of Prostaglandin E1 Plus Lipoic Acid Combination Therapy Versus Monotherapy for Patients With Diabetic Peripheral Neuropathy. J Clin Neurosci. 2016;27:8-16. PubMed PMID: 26775115.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy and safety of prostaglandin E1 plus lipoic acid combination therapy versus monotherapy for patients with diabetic peripheral neuropathy. AU - Jiang,De-Qi, AU - Li,Ming-Xing, AU - Ma,Yan-Jiao, AU - Wang,Yan, AU - Wang,Yong, Y1 - 2016/02/03/ PY - 2014/12/02/received PY - 2015/04/29/revised PY - 2015/07/04/accepted PY - 2016/1/18/entrez PY - 2016/1/18/pubmed PY - 2016/12/15/medline KW - Diabetic peripheral neuropathy KW - Efficacy KW - Lipoic acid KW - Meta-analysis KW - Prostaglandin E1 SP - 8 EP - 16 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 27 N2 - The aim of this report was to evaluate the efficacy and safety of prostaglandin E1 (PGE1) plus lipoic acid (LA) for the treatment of diabetic peripheral neuropathy (DPN) compared with that of PGE1 or LA monotherapy. Randomized controlled trials (RCT) published up to 3 August 2014 were reviewed. A random or fixed effect model was used to analyze outcomes expressed as risk ratios (RR) or mean difference (MD) with a 95% confidence interval (CI). I(2) statistic was used to assess heterogeneity. Subgroup and sensitivity analyses were performed. The outcomes measured were as follows: clinical efficacy, median motor nerve conduction velocity (MNCV), median sensory nerve conduction velocity (SNCV), peroneal MNCV, peroneal SNCV and adverse effects. Thirty-one RCT with 2676 participants were included. Clinical efficacy of PGE1+LA combination therapy was significantly better than monotherapy (p<0.00001, RR=1.32, 95% CI 1.26 to 1.38). Compared with monotherapy, PGE1+LA combination therapy led to significant improvements in median MNCV (p<0.00001, MD=4.69, 95% CI 3.16 to 6.23), median SNCV (p<0.00001, MD=5.46, 95% CI 4.04 to 6.88), peroneal MNCV (p<0.00001, MD=5.19, 95% CI 3.71 to 6.67) and peroneal SNCV (p<0.00001, MD=5.50, 95% CI 3.30 to 7.70). There were no serious adverse events associated with drug intervention. PGE1+LA combination therapy is superior to PGE1 or LA monotherapy for improvement of neuropathic symptoms and nerve conduction velocities in patients with DPN. These findings should be further validated by larger well-designed and high-quality RCT. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/26775115/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(15)00601-3 DB - PRIME DP - Unbound Medicine ER -