Ranking Alpha Lipoic Acid and Gamma Linolenic Acid in Terms of Efficacy and Safety in the Management of Adults With Diabetic Peripheral Neuropathy: A Systematic Review and Network Meta-analysis.

Autor: Prado MB Jr; Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines; Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines Manila, Manila, Philippines. Electronic address: mbprado@alum.up.edu.ph., Adiao KJB; Department of Internal Medicine, Medical Center Manila, Manila, Philippines.
Jazyk: angličtina
Zdroj: Canadian journal of diabetes [Can J Diabetes] 2024 Jun; Vol. 48 (4), pp. 233-243.e10. Date of Electronic Publication: 2024 Jan 29.
DOI: 10.1016/j.jcjd.2024.01.007
Abstrakt: Objectives: Current medications for diabetic neuropathy (DN) recommended by the American Diabetes Association and American Academy of Neurology do not address the pathologic process of denervation among patients with DN, because ancillary treatments, such as reactive oxygen scavengers, may be needed. The purpose of this work was to summarize the available evidence about the efficacy and safety of alpha lipoic acid (ALA) and gamma linolenic acid (GLA) in the management of DN.
Methods: Using the search terms [(alpha lipoic acid or ALA or thioctic acid or thioctacid) or (gamma linolenic acid or GLA)] AND [(diabetes or diabetes mellitus) AND (polyneuropathy or neuropathy or sensorimotor polyneuropathy or radiculopathy)], 11 studies were included in this review and combined meta-analysis.
Results: Eight of the 11 articles (73%) reported significant benefit of ALA vs placebo. In the meta-analysis, the Total Symptom Score (TSS) for ALA 600 mg/day (ALA600) was 1.05 points lower (standard mean difference [SMD] -1.05, 95% confidence interval [CI] -2.07 to -0.04, p=0.04, I 2 =98.18%) compared with control at the end of the study. In the network meta-analysis, ALA600 (SMD -1.68, 95% CI -2.8 to -0.6) and GLA (SMD -2.39, 95% CI -4.3 to -0.5) had significantly lower TSSs compared with placebo. Moreover, GLA had the highest probability of being the best (52.7%) for improving DN symptoms. In all studies, most adverse events include gastrointestinal disturbances. In terms of tolerability, no differences were detected between ALA and control groups.
Conclusion: ALA and GLA appear to be safe and efficacious biofactors for improvement of DN symptoms.
(Copyright © 2024 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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