Stratified analyses for selecting appropriate target patients with diabetic peripheral neuropathy for long-term treatment with an aldose reductase inhibitor, epalrestat
2008

Epalrestat for Diabetic Peripheral Neuropathy

Sample size: 504 publication 10 minutes Evidence: moderate

Author Information

Author(s): Hotta N, Kawamori R, Atsumi Y, Baba M, Kishikawa H, Nakamura J, Oikawa S, Yamada N, Yasuda H, Shigeta Y, The ADCT Study Group

Primary Institution: Chubu Rosai Hospital

Hypothesis

The long-term efficacy of epalrestat in improving subjective symptoms and nerve function in patients with diabetic peripheral neuropathy was assessed.

Conclusion

Epalrestat provides a clinically significant means of preventing and treating diabetic neuropathy if used in appropriate patients.

Supporting Evidence

  • Epalrestat showed better efficacy in patients with good glycaemic control.
  • In the control group, no improvement in nerve function was observed.
  • The odds ratio for the efficacy of epalrestat was approximately 2:1 compared to control subjects.

Takeaway

Epalrestat can help people with diabetes feel better and improve their nerve function if they are in good health.

Methodology

Data from the Aldose Reductase Inhibitor—Diabetes Complications Trial (ADCT) were analyzed, including longitudinal data on HbA1c and subjective symptoms over 3 years.

Potential Biases

Potential bias due to the open-label trial design, although some measures were taken to minimize it.

Limitations

The study design was open-label, which may introduce bias.

Participant Demographics

Patients with diabetic peripheral neuropathy, median motor nerve conduction velocity ≥ 40 m/s, and HbA1c ≤ 9.0%.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI 1.32–2.75

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1111/j.1464-5491.2008.02490.x

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