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Old 04-21-2008, 01:24 PM
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Default Switching to Alpha Lipoic Acid May Improve Diabetic Neuropathy

"Switching from pathogenetic treatment with alpha-lipoic acid to gabapentin and other analgesics in painful diabetic neuropathy: a real-world study in outpatients,"

Ruessmann HJ, et al, J Diabetes Complications, 2008 April 8; [Epub ahead of print].

(Address: Heinz-J�rgen Ruessmann, President, AND, Arbeitsgemeinschaft niedergelassener diabetologish tatiger Arzte e.V, Wilhelminenstr. 22, 46537 Dinslaken, Germany).

In a retrospective, real-world study involving 443 diabetic subjects with chronic, painful neuropathy, switching from regular daily treatment with alpha-lipoic acid for 5 years to treatment with the drug, gabapentin (often sold under the brand names Neurontin or Gabarone), or other pain medications, was found to be associated with considerably more side effects, increased frequency of outpatient visits, and increased daily cost of treatment.

After receiving daily supplementation with alpha-lipoic acid (600 mg/once a day) for an average of 5 years, patients were switched to either gabapentin (600-2400 mg/d) (n=293) or no treatment because of no acute symptoms (n=150). Among the group left untreated, 73% developed neuropathic symptoms 2 weeks after stopping alpha-lipoic acid treatment. Among the group on gabapentin, 45% developed side effects so intolerable that they had to stop taking the drug. Moreover, 55% of the subjects on gabapentin were nonresponders to the drug at doses up to 2400 mg/day, and therefore required treatment with other pain medications (and were given drugs such as pregabalin, carbamazepine, amitriptyline, tramadol, morphine).

Patients on gabapentin or other pain drugs required outpatient visits an average of 7.9 times per 3 months, as compared to only 3.8 times per 3 months while taking alpha-lipoic acid. The authors point out that, "the daily costs for alpha-lipoic acid were considerably lower than those for gabapentin or several frequently used drug combinations."

The authors conclude that daily treatment with alpha-lipoic acid, "…represents for the practicing diabetologist an effective, safe, and cost-effective treatment option for the majority of patients with diabetic polyneuropathy."
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