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DOI: 10.1055/s-0042-107242
The Therapeutic Effect of Pancreatic Kininogenase on Treatment of Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes
Publication History
received 05 January 2016
first decision 12 April 2016
accepted 12 April 2016
Publication Date:
04 October 2016 (online)
Abstract
Background: To determine the therapeutic efficacy and cost-effective of pancreatic kininogenase (PKase) on treatment of diabetic peripheral neuropathy (DPN) compared with Prostaglandin E1 (PGE1) in patients with type 2 diabetes.
Methods: 104 patients with DPN receiving standard glucose control therapy were randomly assigned into 3 groups: Group-A received PKase treatment, Group-B received PGE1 treatment, and Group-C received only standard glucose control therapy. Michigan neuropathy screening instrument (MNSI) score, neurophysiology examination, and nerve conduction velocity were measured.
Results: Standard glucose control therapy significantly reduced hyperglycemia to a similar level in all groups. Questionnaire grading and neurophysiology examination both indicated that no significant difference was found at the end of treatment between Groups -A and -B. Except for the ulnar nerve sensory conduction velocity that was significantly improved in Group-B, the remaining nerve conduction velocity (regardless of sensory or motor nerve conduction velocities) was improved to a similar level in Groups -A and -B. Group-A had significantly reduced questionnaire grading and better improvement in motor nerve conduction velocity of the common peroneal nerve, ulnar nerve, and sensory nerve conduction velocity of the sural nerve as compared with Group-C. However, the medical cost of PKase was only 18.9% of that of PGE1 during one course of treatment.
Conclusions: PKase has the similar therapeutic efficacy as PGE1 on treatment of DPN in patients with type 2 diabetes. However, the medical cost of PKase is one fifth of that of PGE1. Thus, PKase is a cost-effective drug for treatment of DPN.
Key words
pancreatic kininogenase - type 2 diabetes - diabetic peripheral neuropathy - medical expense* equal contribution
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References
- 1 Vinik AI, Nevoret ML, Casellini C et al. Diabetic neuropathy. Endocrinology and metabolism clinics of North America 2013; 42: 747-787
- 2 Chinese Diabetes S and Chinese Medical A. A nationwide retrospective analysis on chronic diabetic complications and related macrovascular diseases of in-patients with diabetes during 1991–2000. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2002; 24: 447-451
- 3 Little AA, Edwards JL, Feldman EL. Diabetic neuropathies. Practical neurology 2007; 7: 82-92
- 4 Cade WT. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther 2008; 88: 1322-1335
- 5 Haak E, Usadel KH, Kusterer K et al. Effects of alpha-lipoic acid on microcirculation in patients with peripheral diabetic neuropathy. Exp Clin Endocrinol Diabetes 2000; 108: 168-174
- 6 Han T, Bai J, Liu W et al. A systematic review and meta-analysis of alpha-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol 2012; 167: 465-471
- 7 Papanas N, Ziegler D. Efficacy of alpha-lipoic acid in diabetic neuropathy. Expert Opin Pharmacother 2014; 15: 2721-2731
- 8 Ramirez MA, Borja NL. Epalrestat: an aldose reductase inhibitor for the treatment of diabetic neuropathy. Pharmacotherapy 2008; 28: 646-655
- 9 Itoh Y, Yasui T, Kakizawa H et al. The therapeutic effect of lipo PGE1 on diabetic neuropathy-changes in endothelin and various angiopathic factors. Prostaglandins Other Lipid Mediat 2001; 66: 221-234
- 10 Toyota T, Hirata Y, Ikeda Y et al. a new lipid-encapsulated preparation of prostaglandin E1: placebo-and prostaglandin E1-controlled multicenter trials in patients with diabetic neuropathy and leg ulcers. Prostaglandins 1993; 46: 453-468
- 11 Akahori H, Takamura T, Hayakawa T et al. Prostaglandin E1 in lipid microspheres ameliorates diabetic peripheral neuropathy: clinical usefulness of Semmes-Weinstein monofilaments for evaluating diabetic sensory abnormality. Diabetes Res Clin Pract 2004; 64: 153-159
- 12 Hong L, Zhang J, Shen J. Clinical efficacy of different doses of lipo-prostaglandin E1 in the treatment of painful diabetic peripheral neuropathy. J Diabetes Complications 2015; 29: 1283-1286
- 13 Ye L, Zhang S, Greder L et al. Effective cardiac myocyte differentiation of human induced pluripotent stem cells requires VEGF. PloS one 2013; 8: e53764
- 14 Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15: 539-553
- 15 Uttara B, Singh AV, Zamboni P et al. Oxidative stress and neurodegenerative diseases: a review of upstream and downstream antioxidant therapeutic options. Curr Neuropharmacol 2009; 7: 65-74
- 16 Baba M. Progress in therapy for and diagnosis of diabetic neuropathies. Nihon Naika Gakkai Zasshi 2009; 98: 779-786
- 17 Ryle C, Donaghy M. Non-enzymatic glycation of peripheral nerve proteins in human diabetics. Journal of the neurological sciences 1995; 129: 62-68
- 18 Son SM, Whalin MK, Harrison DG et al. Oxidative stress and diabetic vascular complications. Curr Diab Rep 2004; 4: 247-252
- 19 Cameron NE, Eaton SE, Cotter MA et al. Vascular factors and metabolic interactions in the pathogenesis of diabetic neuropathy. Diabetologia 2001; 44: 1973-1988