Effects of Prostaglandin E1 Plus Methylcobalamin Alone and in Combination With Lipoic Acid on Nerve Conduction Velocity in Patients With Diabetic Peripheral Neuropathy: A Meta-Analysis

Neurosci Lett. 2015 May 6;594:23-9. doi: 10.1016/j.neulet.2015.03.037. Epub 2015 Mar 20.

Abstract

This report was to evaluate the efficacy of lipoic acid, prostaglandin E1 and methylcobalamin (L+P+M) for the treatment of diabetic peripheral neuropathy (DPN) in comparison with that of prostaglandin E1 plus methylcobalamin (P+M), in order to provide the basis and reference for clinical rational drug use. Randomized controlled trials (RCTs) of L+P+M for DPN published up to 3rd August, 2014 were searched. A random or fixed effect model was used to analyze outcomes which were expressed as risk ratios (RRs) or mean difference (MD) with a 95% confidence interval (CI). Eighteen RCTs with 1410 participants were included. Clinical efficacy of L+P+M therapy was significantly better than P+M therapy (fifteen trials; RR 1.32, 95% CI 1.24-1.41, P<0.00001, I(2)=32%). As compared with P+M therapy, the pooled effects of L+P+M therapy on nerve conduction velocities (NCVs) were (fifteen trials; MD 4.70, 95% CI 3.77-5.63, P<0.00001, I(2)=79%) for median MNCV, (thirteen trials; MD 4.73, 95% CI 3.69-5.77, P<0.00001, I(2)=85%) for median SNCV, (sixteen trials; MD 4.22, 95% CI 3.32-5.12, P<0.00001, I(2)=83%) for peroneal MNCV, (fourteen trials; MD 3.09, 95% CI 2.04-4.14, P<0.00001, I(2)=82%) for peroneal SNCV. There was no serious adverse events associated with drugs intervention. L+P+M therapy was superior to P+M therapy for improvement of clinical efficacy and NCVs in DPN patients. These findings should be further verified by high-quality RCTs.

Keywords: Diabetic peripheral neuropathy; Lipoic acid; Meta-analysis; Methylcobalamin; Nerve conduction velocity; Prostaglandin E1.

Publication types

  • Meta-Analysis

MeSH terms

  • Alprostadil / therapeutic use*
  • Diabetic Neuropathies / drug therapy*
  • Diabetic Neuropathies / physiopathology
  • Drug Therapy, Combination
  • Humans
  • Neural Conduction / drug effects*
  • Randomized Controlled Trials as Topic
  • Thioctic Acid / therapeutic use*
  • Vitamin B 12 / analogs & derivatives*
  • Vitamin B 12 / therapeutic use

Substances

  • Thioctic Acid
  • mecobalamin
  • Alprostadil
  • Vitamin B 12