title: 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.
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.
authors: Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China; Department of Biopharmaceutical, Yulin Normal University, Yulin 537000, China.
authors: De-Qi
authors: DQ
authors: Jiang
authors: Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China.
authors: Ming-Xing
authors: MX
authors: Li
authors: Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China.
authors: Yan
authors: Y
authors: Wang
authors: Department of Pharmacy, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China. Electronic address: yongwh2005@hotmail.com.
authors: Yong
authors: Y
authors: Wang
mesh_terms: D000527:Alprostadil / Q000627:therapeutic use*; D003929:Diabetic Neuropathies / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D006801:Humans; D009431:Neural Conduction / Q000187:drug effects*; D016032:Randomized Controlled Trials as Topic; D008063:Thioctic Acid / Q000627:therapeutic use*; D014805:Vitamin B 12 / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D008063:Thioctic Acid; C019476:mecobalamin; D000527:Alprostadil; D014805:Vitamin B 12
keywords: Diabetic peripheral neuropathy; Lipoic acid; Meta-analysis; Methylcobalamin; Nerve conduction velocity; Prostaglandin E1