Effect of the combination of uridine nucleotides, folic acid and vitamin B12 on the clinical expression of peripheral neuropathies.
OBJECTIVE
Peripheral neuropathy (PN) is a common condition whose incidence is approximately 8% in elderly persons. Neuropathic pain (NeP) has a significant incidence in the general population and affects more than half of all patients with PN. The pathophysiology of PN is characterized by lesions of myelin-producing Schwann cells in peripheral nerves. Regeneration/protection of the myelin sheath after a nerve lesion is a fundamental element of repair in PN. Nucleotides such as uridine monophosphate (UMP) have proven to be efficacious in treating the cause of the myelin sheath lesion in several experimental and clinical models. Our objective was to evaluate clinical improvement in patients with PN and NeP treated with a combination of UMP+folic acid+vitamin B12 (Keltican).


METHODS
We performed an exploratory, open-label, multicenter, study of 212 patients followed for 2 months. Pain was assessed using the painDETECT questionnaire (PDQ).


RESULTS
The intensity of the NeP assessed at the time of the consultation progressed favorably and decreased significantly (p<0.001) in all the types of PN included. The global score for pain assessed using PDQ decreased from 17.5 points to 8.8 points at the final evaluation (p<0.001). Nonsteroidal anti-inflammatory drugs were decreased/withdrawn in 77.4% of patients.


CONCLUSIONS
The combination of UMP+folic acid+vitamin B12 is effective against NeP associated with PN. It leads to statistically significant reductions not only in the total PDQ score but also in the intensity of pain, number of areas affected, and pain radiation. Furthermore, it makes it possible to reduce the dosage of concomitant medication.
Service of Neurology. Hospital Universitario. Ladeira da Porteladinha, No. 46, 3030-203 Coimbra, Portugal.
Luis
L
Negrão
Pedro
P
Almeida
Sérgio
S
Alcino
Helena
H
Duro
Teresa
T
Libório
Ulisses
U
Melo Silva
Ricardo
R
Figueira
Sílvia
S
Gonçalves
Laura
L
Neto Parra
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy*; D011320:Primary Health Care; D011446:Prospective Studies; D014500:Uracil Nucleotides / Q000627:therapeutic use*; D014542:Uridine Monophosphate / Q000627:therapeutic use; D014805:Vitamin B 12 / Q000627:therapeutic use*; D055815:Young Adult
D000700:Analgesics; D014500:Uracil Nucleotides; D005492:Folic Acid; D014542:Uridine Monophosphate; D014805:Vitamin B 12
neuropathic pain; nucleotides; peripheral neuropathy; uridine monophosphate