Disease-modifying therapies for diabetic peripheral neuropathy: A systematic review and meta-analysis of randomized controlled trials

被引:5
作者
Ran, Gui -Lin [1 ]
Li, Yan-Ping
Lu, Li-Chin [1 ]
Lan, Shao-Huan [1 ,2 ,3 ,4 ,5 ]
机构
[1] Fujian Med Univ, Sch Pharm, Fuzhou, Fujian, Peoples R China
[2] Putian Univ, Affiliated Hosp, Putian 351100, Peoples R China
[3] Putian Univ, Sch Management, Putian 351100, Peoples R China
[4] Putian Univ, Sch Pharmaceut Sci & Med Technol, Putian 351100, Peoples R China
[5] Putian Univ, Sch Pharmaceut Sci & Med Technol, 1133 Xueyuan Rd, Putian 351100, Fujian, Peoples R China
关键词
Diabetic peripheral neuropathy; Alpha-lipoic acid; Epalrestat; Mecobalamin; Meta-analysis; ALPHA-LIPOIC ACID; DOUBLE-BLIND; EPALRESTAT; POLYNEUROPATHY; COMBINATION;
D O I
10.1016/j.jdiacomp.2024.108691
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Alpha-lipoic acid, epalrestat, and mecobalamin are widely used as monotherapies for diabetic peripheral neuropathy. However, whether a triple-combination therapy with these three drugs is superior to monotherapy or dual therapy remains debatable. Methods: Nine randomized controlled trials were identified through a search on electronic databases such as PubMed, Web of Science, and Cochrane Library. The trial participants (N = 1153) were divided into the experimental group who received the triple-combination therapy and the control group who received conventional or dual therapy with the aforementioned drugs. Results: Therapeutic outcomes were better in the experimental group than in the control group (odds ratio: 3.74; 95 % confidence interval: 2.57-5.45; I-2 = 0 %; p < 0.00001). No statistic difference was noted in adverse effects. Compared with the control group, the experimental group exhibited significant improvements in median motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV), peroneal MNCV, peroneal SNCV, and vibration perception thresholds (VPT) in the left and right lower limbs. In the control group, a subgroup analysis by treatment strategy revealed similar improvements in total efficacy, MNCV, and SNCV. Conclusions: For diabetic peripheral neuropathy, the triple-combination therapy may be more effective than monotherapy or dual therapy.
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页数:9
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