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

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Canadian Journal of Diabetes Pub Date : 2024-06-01 DOI:10.1016/j.jcjd.2024.01.007

Mario B. Prado Jr MD , Karen Joy B. Adiao MD

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引用次数: 0

Abstract

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, I²=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.

查看原文本刊更多论文

对α-硫辛酸和γ-亚麻酸治疗糖尿病周围神经病变的有效性和安全性进行排名：系统综述与网络元分析

背景美国糖尿病学会（ADA）和美国神经病学学会（AAN）推荐的治疗糖尿病神经病变（DN）的现有药物并不能解决DN患者神经支配的病理过程，因此可能需要使用活性氧清除剂（ROS）等辅助治疗。本文旨在总结有关α-硫辛酸（ALA）和γ-亚麻酸（GLA）在治疗 DN 方面的有效性和安全性的现有证据。结果 11 篇论文中有 8 篇（73%）报告了 ALA 对安慰剂的显著疗效。在荟萃分析中，研究结束时，ALA600的症状总评分（TSS）比对照组低1.05分（SMD：-1.05，CI：-2.07至-0.04，P=0.04，I2=98.18%）。在网络荟萃分析中，与安慰剂相比，ALA600（SMD：-1.68，CI：-2.8至-0.6）和GLA（SMD：-2.39，CI：-4.3至-0.5）的TSS显著降低。此外，在改善 DN 症状方面，GLA 的最佳概率最高（52.7%）。在所有研究中，大多数不良反应包括消化道紊乱。在耐受性方面，ALA 组与对照组之间未发现差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

4.80

自引率

4.00%

发文量

130

审稿时长

54 days

期刊介绍： The Canadian Journal of Diabetes is Canada''s only diabetes-oriented, peer-reviewed, interdisciplinary journal for diabetes health-care professionals. Published bimonthly, the Canadian Journal of Diabetes contains original articles; reviews; case reports; shorter articles such as Perspectives in Practice, Practical Diabetes and Innovations in Diabetes Care; Diabetes Dilemmas and Letters to the Editor.