Alpha Lipoic Acid For Diabetic Peripheral Neuropathy:A Systemetic Review

Objective To systemically review and investigate the efficacy and safety of alpha lipoic acid for diabetic peripheral neuropathy.Methods To search EMBASE, MEDLINE, Cochrane Library databases, WANFANG DATA, VIP, CNKI up to January2012. the quality of randomized controlled trials assessing alpha lipoic acid for diabetic peripheral neuropaphy was evaluated. And the extracted data were calculated by the software Stata11.0with Meta.Result Six trials were involving1271participants with diabetic peripheral neuropaphy.There were751participants in alpha lipoic acid group and520participants in control group.The results of Meta-analysis showed:①Alpha lipoic acid was more effective than placebo in decreasing total symptoms of score(TSS) from baseline [P<0.001, SMD=-0.618,95%CI(-0.867,-0.369)]. Subgroup analyses showed that low or high dose, oral or intravenously administration, short-term or long-term treatment of alpha lipoic acid lead to reduction in TSS versus placebo. Subgroup analyses of dose therapy maybe contributed to the clinical heterogeneity of the overall result;②ndividual symptom scores of pain, burning sensation, paresthesia or numbness were significantly diminished in favour of alpha lipoic acid. The effect sizes was [P<0.001, SMD=-0.731,95%CI (-1.088,-0.374)],[P<0.001, SMD=-0.658,95%CI (-0.833,-0.482)],[P<0.001, SMD=-0.297,95%CI(-0.469,-0.125)],[P<0.001, SMD=-0.731,95%CI (-1.088,-0.374)], respectively;③ompared with placebo, alpha lipoic acid was more effective in reducing neuropathy impairment score(NIS) and NIS of the lower limb [P=0.035, SMD=-0.120,95%CI(-0.232,-0.008)],[P=0.015, SMD=-0.146,95%CI(-0.264,-0.028)];④Safety analysis showed that, most adverse events were mild to moderate in severity. The incidence of adverse events did not differ between the groups. The most frequently reported adverse events were headache, vertigo, nausea, vomiting and so on. Only one study over four years showed that the rate of serious adverse events was numerically higher with alpha lipoic acid than with placebo, but the difference between treatments was not statistically significant.Conclusions Alpha lipoic acid has good effects on patients with diabetic peripheral neuropaphy, improving for clinical symptoms and physical sign. Adverse events of its were relatively slighter.The efficacy of alpha lipoic acid is sustained with good safety and tolerability profiles.