Efficacy and Safety of Antioxidant Treatment With α-Lipoic Acid Over 4 Years in Diabetic Polyneuropathy: The NATHAN 1 trial
OBJECTIVE: To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy (DSPN). RESEARCH DESIGN AND METHODS: In a multicenter randomized double-blind parallel-group trial, 460 diabetic patients with mild-to-moderate...
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| Published in | Diabetes care Vol. 34; no. 9; pp. 2054 - 2060 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Alexandria, VA
American Diabetes Association
01.09.2011
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0149-5992 1935-5548 1935-5548 |
| DOI | 10.2337/dc11-0503 |
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| Abstract | OBJECTIVE: To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy (DSPN). RESEARCH DESIGN AND METHODS: In a multicenter randomized double-blind parallel-group trial, 460 diabetic patients with mild-to-moderate DSPN were randomly assigned to oral treatment with 600 mg ALA once daily (n = 233) or placebo (n = 227) for 4 years. Primary end point was a composite score (Neuropathy Impairment Score [NIS]–Lower Limbs [NIS-LL] and seven neurophysiologic tests). Secondary outcome measures included NIS, NIS-LL, nerve conduction, and quantitative sensory tests (QSTs). RESULTS: Change in primary end point from baseline to 4 years showed no significant difference between treatment groups (P = 0.105). Change from baseline was significantly better with ALA than placebo for NIS (P = 0.028), NIS-LL (P = 0.05), and NIS-LL muscular weakness subscore (P = 0.045). More patients showed a clinically meaningful improvement and fewer showed progression of NIS (P = 0.013) and NIS-LL (P = 0.025) with ALA than with placebo. Nerve conduction and QST results did not significantly worsen with placebo. Global assessment of treatment tolerability and discontinuations due to lack of tolerability did not differ between the groups. The rates of serious adverse events were higher on ALA (38.1%) than on placebo (28.0%). CONCLUSIONS: Four-year treatment with ALA in mild-to-moderate DSPN did not influence the primary composite end point but resulted in a clinically meaningful improvement and prevention of progression of neuropathic impairments and was well tolerated. Because the primary composite end point did not deteriorate significantly in placebo-treated subjects, secondary prevention of its progression by ALA according to the trial design was not feasible. |
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| AbstractList | OBJECTIVE--To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mildto-moderate diabetic distal symmetric sensorimotor polyneuropathy (DSPN). RESEARCH DESIGN AND METHODS--In a multicenter randomized double-blind parallel-group trial, 460 diabetic patients with mild-to-moderate DSPN were randomly assigned to oral treatment with 600 mg ALA once daily (n = 233) or placebo (n = 227) for 4 years. Primary end point was a composite score (Neuropathy Impairment Score [NIS]-Lower Limbs [NIS-LL] and seven neurophysiologic tests). Secondary outcome measures included NIS, NIS-LL, nerve conduction, and quantitative sensory tests (QSTs). RESULTS--Change in primary end point from baseline to 4 years showed no significant difference between treatment groups (P = 0.105). Change from baseline was significantly better with ALA than placebo for NIS (P = 0.028), NIS-LL (P = 0.05), and NIS-LL muscular weakness subscore (P = 0.045). More patients showed a clinically meaningful improvement and fewer showed progression of NIS (P = 0.013) and NIS-LL (P = 0.025) with ALA than with placebo. Nerve conduction and QST results did not significantly worsen with placebo. Global assessment of treatment tolerability and discontinuations due to lack of tolerability did not differ between the groups. The rates of serious adverse events were higher on ALA (38.1%) than on placebo (28.0%). CONCLUSIONS--Four-year treatment with ALA in mild-to-moderate DSPN did not influence the primary composite end point but resulted in a clinically meaningful improvement and prevention of progression of neuropathic impairments and was well tolerated. Because the primary composite end point did not deteriorate significantly in placebo-treated subjects, secondary prevention of its progression by ALA according to the trial design was not feasible. OBJECTIVE: To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy (DSPN). RESEARCH DESIGN AND METHODS: In a multicenter randomized double-blind parallel-group trial, 460 diabetic patients with mild-to-moderate DSPN were randomly assigned to oral treatment with 600 mg ALA once daily (n = 233) or placebo (n = 227) for 4 years. Primary end point was a composite score (Neuropathy Impairment Score [NIS]–Lower Limbs [NIS-LL] and seven neurophysiologic tests). Secondary outcome measures included NIS, NIS-LL, nerve conduction, and quantitative sensory tests (QSTs). RESULTS: Change in primary end point from baseline to 4 years showed no significant difference between treatment groups (P = 0.105). Change from baseline was significantly better with ALA than placebo for NIS (P = 0.028), NIS-LL (P = 0.05), and NIS-LL muscular weakness subscore (P = 0.045). More patients showed a clinically meaningful improvement and fewer showed progression of NIS (P = 0.013) and NIS-LL (P = 0.025) with ALA than with placebo. Nerve conduction and QST results did not significantly worsen with placebo. Global assessment of treatment tolerability and discontinuations due to lack of tolerability did not differ between the groups. The rates of serious adverse events were higher on ALA (38.1%) than on placebo (28.0%). CONCLUSIONS: Four-year treatment with ALA in mild-to-moderate DSPN did not influence the primary composite end point but resulted in a clinically meaningful improvement and prevention of progression of neuropathic impairments and was well tolerated. Because the primary composite end point did not deteriorate significantly in placebo-treated subjects, secondary prevention of its progression by ALA according to the trial design was not feasible. To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy (DSPN). RESEARCH DESIGN AND METHODS In a multicenter randomized double-blind parallel-group trial, 460 diabetic patients with mild-to-moderate DSPN were randomly assigned to oral treatment with 600 mg ALA once daily (n = 233) or placebo (n = 227) for 4 years. Primary end point was a composite score (Neuropathy Impairment Score [NIS]-Lower Limbs [NIS-LL] and seven neurophysiologic tests). Secondary outcome measures included NIS, NIS-LL, nerve conduction, and quantitative sensory tests (QSTs). Change in primary end point from baseline to 4 years showed no significant difference between treatment groups (P = 0.105). Change from baseline was significantly better with ALA than placebo for NIS (P = 0.028), NIS-LL (P = 0.05), and NIS-LL muscular weakness subscore (P = 0.045). More patients showed a clinically meaningful improvement and fewer showed progression of NIS (P = 0.013) and NIS-LL (P = 0.025) with ALA than with placebo. Nerve conduction and QST results did not significantly worsen with placebo. Global assessment of treatment tolerability and discontinuations due to lack of tolerability did not differ between the groups. The rates of serious adverse events were higher on ALA (38.1%) than on placebo (28.0%). Four-year treatment with ALA in mild-to-moderate DSPN did not influence the primary composite end point but resulted in a clinically meaningful improvement and prevention of progression of neuropathic impairments and was well tolerated. Because the primary composite end point did not deteriorate significantly in placebo-treated subjects, secondary prevention of its progression by ALA according to the trial design was not feasible. To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy (DSPN). RESEARCH DESIGN AND METHODS In a multicenter randomized double-blind parallel-group trial, 460 diabetic patients with mild-to-moderate DSPN were randomly assigned to oral treatment with 600 mg ALA once daily (n = 233) or placebo (n = 227) for 4 years. Primary end point was a composite score (Neuropathy Impairment Score [NIS]-Lower Limbs [NIS-LL] and seven neurophysiologic tests). Secondary outcome measures included NIS, NIS-LL, nerve conduction, and quantitative sensory tests (QSTs).OBJECTIVETo evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy (DSPN). RESEARCH DESIGN AND METHODS In a multicenter randomized double-blind parallel-group trial, 460 diabetic patients with mild-to-moderate DSPN were randomly assigned to oral treatment with 600 mg ALA once daily (n = 233) or placebo (n = 227) for 4 years. Primary end point was a composite score (Neuropathy Impairment Score [NIS]-Lower Limbs [NIS-LL] and seven neurophysiologic tests). Secondary outcome measures included NIS, NIS-LL, nerve conduction, and quantitative sensory tests (QSTs).Change in primary end point from baseline to 4 years showed no significant difference between treatment groups (P = 0.105). Change from baseline was significantly better with ALA than placebo for NIS (P = 0.028), NIS-LL (P = 0.05), and NIS-LL muscular weakness subscore (P = 0.045). More patients showed a clinically meaningful improvement and fewer showed progression of NIS (P = 0.013) and NIS-LL (P = 0.025) with ALA than with placebo. Nerve conduction and QST results did not significantly worsen with placebo. Global assessment of treatment tolerability and discontinuations due to lack of tolerability did not differ between the groups. The rates of serious adverse events were higher on ALA (38.1%) than on placebo (28.0%).RESULTSChange in primary end point from baseline to 4 years showed no significant difference between treatment groups (P = 0.105). Change from baseline was significantly better with ALA than placebo for NIS (P = 0.028), NIS-LL (P = 0.05), and NIS-LL muscular weakness subscore (P = 0.045). More patients showed a clinically meaningful improvement and fewer showed progression of NIS (P = 0.013) and NIS-LL (P = 0.025) with ALA than with placebo. Nerve conduction and QST results did not significantly worsen with placebo. Global assessment of treatment tolerability and discontinuations due to lack of tolerability did not differ between the groups. The rates of serious adverse events were higher on ALA (38.1%) than on placebo (28.0%).Four-year treatment with ALA in mild-to-moderate DSPN did not influence the primary composite end point but resulted in a clinically meaningful improvement and prevention of progression of neuropathic impairments and was well tolerated. Because the primary composite end point did not deteriorate significantly in placebo-treated subjects, secondary prevention of its progression by ALA according to the trial design was not feasible.CONCLUSIONSFour-year treatment with ALA in mild-to-moderate DSPN did not influence the primary composite end point but resulted in a clinically meaningful improvement and prevention of progression of neuropathic impairments and was well tolerated. Because the primary composite end point did not deteriorate significantly in placebo-treated subjects, secondary prevention of its progression by ALA according to the trial design was not feasible. |
| Audience | Professional |
| Author | Schütte, Klemens Boulton, Andrew J.M Low, Phillip A Munzel, Ullrich Samigullin, Rustem Ziegler, Dan Dyck, Peter J Vinik, Aaron I Freeman, Roy Litchy, William J Maus, Joachim Tritschler, Hans |
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| Keywords | Endocrinopathy Human Lipoic acid Nervous system diseases Trial Nutrition Toxicity Diabetes mellitus Treatment efficiency Metabolic diseases Antioxidant Polyneuropathy Treatment Clinical trial Peripheral nerve disease Safety Endocrinology |
| Language | English |
| License | CC BY 4.0 Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
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| References | 3277049 - Muscle Nerve. 1988 Jan;11(1):21-32 19399887 - Ann Neurol. 2009 Apr;65(4):386-93 9222195 - Neurology. 1997 Jul;49(1):229-39 17901534 - Diabetes Care. 2007 Oct;30(10):2752-3 16199243 - Clin Ther. 2005 Aug;27(8):1164-80 1603343 - Neurology. 1992 Jun;42(6):1164-70 7668839 - Ann Neurol. 1995 Sep;38(3):478-82 19366965 - Diabetes Care. 2009 Jul;32(7):1256-60 15655130 - Circulation. 2005 Jan 25;111(3):343-8 18039804 - Diabetes Care. 2008 Mar;31(3):464-9 15333481 - Diabetes Care. 2004 Sep;27(9):2178-83 21187189 - Am J Med. 2011 Jan;124(1):85.e1-8 18539916 - N Engl J Med. 2008 Jun 12;358(24):2560-72 18256393 - N Engl J Med. 2008 Feb 7;358(6):580-91 17065669 - Diabetes Care. 2006 Nov;29(11):2365-70 12610036 - Diabetes Care. 2003 Mar;26(3):770-6 19092145 - N Engl J Med. 2009 Jan 8;360(2):129-39 15073746 - Pharmacoepidemiol Drug Saf. 1998 Jan;7(1):51-7 17623822 - Diabetes Care. 2007 Oct;30(10):2626-32 12198820 - Int Rev Neurobiol. 2002;50:431-63 20335313 - Ann Intern Med. 2010 Jun 1;152(11):726-32 17513707 - Diabetes Care. 2007 Oct;30(10):2619-25 14984445 - Diabet Med. 2004 Feb;21(2):114-21 15793206 - Diabetes Care. 2005 Apr;28(4):956-62 |
| References_xml | – reference: 18539916 - N Engl J Med. 2008 Jun 12;358(24):2560-72 – reference: 3277049 - Muscle Nerve. 1988 Jan;11(1):21-32 – reference: 19399887 - Ann Neurol. 2009 Apr;65(4):386-93 – reference: 18039804 - Diabetes Care. 2008 Mar;31(3):464-9 – reference: 21187189 - Am J Med. 2011 Jan;124(1):85.e1-8 – reference: 9222195 - Neurology. 1997 Jul;49(1):229-39 – reference: 1603343 - Neurology. 1992 Jun;42(6):1164-70 – reference: 7668839 - Ann Neurol. 1995 Sep;38(3):478-82 – reference: 17623822 - Diabetes Care. 2007 Oct;30(10):2626-32 – reference: 15073746 - Pharmacoepidemiol Drug Saf. 1998 Jan;7(1):51-7 – reference: 17513707 - Diabetes Care. 2007 Oct;30(10):2619-25 – reference: 15655130 - Circulation. 2005 Jan 25;111(3):343-8 – reference: 12610036 - Diabetes Care. 2003 Mar;26(3):770-6 – reference: 19366965 - Diabetes Care. 2009 Jul;32(7):1256-60 – reference: 14984445 - Diabet Med. 2004 Feb;21(2):114-21 – reference: 15793206 - Diabetes Care. 2005 Apr;28(4):956-62 – reference: 17901534 - Diabetes Care. 2007 Oct;30(10):2752-3 – reference: 12198820 - Int Rev Neurobiol. 2002;50:431-63 – reference: 16199243 - Clin Ther. 2005 Aug;27(8):1164-80 – reference: 20335313 - Ann Intern Med. 2010 Jun 1;152(11):726-32 – reference: 17065669 - Diabetes Care. 2006 Nov;29(11):2365-70 – reference: 18256393 - N Engl J Med. 2008 Feb 7;358(6):580-91 – reference: 19092145 - N Engl J Med. 2009 Jan 8;360(2):129-39 – reference: 15333481 - Diabetes Care. 2004 Sep;27(9):2178-83 |
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| Snippet | OBJECTIVE: To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy... To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mild-to-moderate diabetic distal symmetric sensorimotor polyneuropathy (DSPN).... OBJECTIVE--To evaluate the efficacy and safety of α-lipoic acid (ALA) over 4 years in mildto-moderate diabetic distal symmetric sensorimotor polyneuropathy... |
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| SubjectTerms | Adolescent Adult adverse effects Antioxidants Antioxidants - adverse effects Antioxidants - therapeutic use Biological and medical sciences Diabetes Diabetes. Impaired glucose tolerance Diabetic Neuropathies Diabetic Neuropathies - drug therapy Diabetic Neuropathies - pathology Diabetics Diet therapy drug therapy Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Humans lipoic acid Male Medical sciences Metabolic diseases Middle Aged Miscellaneous nerve tissue oral administration Original Research pathology patients peripheral nervous system diseases Polyneuropathies Public health. Hygiene Public health. Hygiene-occupational medicine therapeutic use Thioctic Acid Thioctic Acid - adverse effects Thioctic Acid - therapeutic use Treatment Outcome Young Adult |
| Title | Efficacy and Safety of Antioxidant Treatment With α-Lipoic Acid Over 4 Years in Diabetic Polyneuropathy: The NATHAN 1 trial |
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