Efficacy of epalrestat, duloxetine and epalrestat in combination with methylcobalamine in diabetic peripheral neuropathy

Abstract

Diabetic neuropathy is a major long term problem allied with diabetes that can cause serious disability and also death. Fifty to seventy five percent of all ulcerations and non trauma amputations are a consequence of diabetic neuropathy. Epalrestat, duloxetine and epalrestat with methylcobalamine are widely used to overcome neuronal damage. This study was designed to evaluate the efficacy of these three drug regimens. Material and methods: Patients included in this study were experiencing pain because of diabetic neuropathy for more than 6 months but not more than 5 years. Results: From 236 subjects with diabetic neuropathy included in the study, 181 patients concluded final analysis. 55 patients dropped from the study (14, 23 and 18 patients from duloxetine, epalrestat+methylcobalamine combination and epalrestat respectively). Mean pain score was reduced from 5.01±1.99 (severe pain) at first visit to 2.86±2.10 (moderate pain) in the epalrestat group, from 6.41±1.73 (severe pain) at first visit to 2.38±1.58 (mild pain) in the duloxetine group and from 5.86±1.76 (severe pain) to 2.88±1.91 (mild pain) in the epalrestat with methylcobalamine group. Conclusion: We conclude that duloxetine was significantly more effective than epalrestat and epalrestat in combination with methylcobalamine in relieving diabetic neuropathic pain.