Treatment withα-Lipoic Acid over 16 Weeks in Type 2 Diabetic Patients with Symptomatic Polyneuropathy Who Responded to Initial 4-Week High-Dose Loading

Author:

Garcia-Alcala Hector1,Santos Vichido Celia Isabel2,Islas Macedo Silverio3,Genestier-Tamborero Christelle Nathalie1,Minutti-Palacios Marissa1,Hirales Tamez Omara1,García Carlos1,Ziegler Dan45

Affiliation:

1. Departamento de Ciencias de Salud, Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, Calle 21 Sur 1103, Barrio de Santiago, 72410 Puebla, Mexico

2. Outpatient Diabetes Clinic PEMEX, Calle 46 Poniente 1502, Colonia Cleotilde Torres, 72050 Puebla, Mexico

3. Hospital Universitario de Puebla, Benemerita Universidad Autonoma de Puebla, Avenida 25 Poniente 1301, Colonia Los Volcanes, 72410 Puebla, Mexico

4. Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany

5. Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany

Abstract

Effective treatment of diabetic sensorimotor polyneuropathy remains a challenge. To assess the efficacy and safety ofα-lipoic acid (ALA) over 20 weeks, we conducted a multicenter randomized withdrawal open-label study, in which 45 patients with type 2 diabetes and symptomatic polyneuropathy were initially treated with ALA (600 mg tid) for 4 weeks (phase 1). Subsequently, responders were randomized to receive ALA (600 mg qd;n=16) or to ALA withdrawal (n=17) for 16 weeks (phase 2). During phase 1, the Total Symptom Score (TSS) decreased from 8.9 ± 1.8 points to 3.46 ± 2.0 points. During phase 2, TSS improved from 3.7 ± 1.9 points to 2.5 ± 2.5 points in the ALA treated group (p<0.05) and remained unchanged in the ALA withdrawal group. The use of analgesic rescue medication was higher in the ALA withdrawal group than ALA treated group (p<0.05). In conclusion, in type 2 diabetic patients with symptomatic polyneuropathy who responded to initial 4-week high-dose (600 mg tid) administration of ALA, subsequent treatment with ALA (600 mg qd) over 16 weeks improved neuropathic symptoms, whereas ALA withdrawal was associated with a higher use of rescue analgesic drugs. This trial is registered with ClinicalTrials.gov Identifier:NCT02439879.

Funder

MEDA Pharma GmbH & Co. KG

Publisher

Hindawi Limited

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism

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