WITHDRAWAL OF THE ALDOSE REDUCTASE INHIBITOR TOLRESTAT IN PATIENTS WITH DIABETIC NEUROPATHY - EFFECT ON NERVE FUNCTION

被引：68

作者：

SANTIAGO, JV

SONKSEN, PH

BOULTON, AJM

MACLEOD, A

BEG, M

BOCHENEK, W

GRAEPEL, GJ

GONEN, B

机构：

[1] Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, MO

[2] Department of Endocrinology and Chemical Pathology, University of London, London, United Medical and Dental Schools Guy's and St. Thomas' Hospitals

[3] Department of Medicine and Clinical Pharmacology, University of Manchester

[4] Clinical Research and Development, Wyeth-Ayerst Research, Radnor, PA

来源：

JOURNAL OF DIABETES AND ITS COMPLICATIONS | 1993年 / 7卷 / 03期

关键词：

D O I：

10.1016/1056-8727(93)90042-W

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A double-blind, placebo-controlled clinical trial was conducted to study the effects of discontinuing tolrestat, an aldose reductase inhibitor, on peripheral sensorimotor diabetic neuropathy. After an average of 4.2 years of continuous tolrestat use, 372 patients were randomly assigned to either placebo or continued tolrestat therapy and were followed for 52 weeks. After 3 months, patients who perceived worsening of symptoms of neuropathy were allowed to switch once to the alternate treatment group while maintaining the double-blind. Patients assigned to placebo had significant deterioration in motor nerve conduction velocity (MNCV) while those maintained on tolrestat did not (p < 0.05). The 28 patients who were randomly assigned to tolrestat and elected to switch to placebo had a significant deterioration in MNCV while the 36 assigned to placebo who switched to tolrestat had a significant improvement (p < 0.05). Treatment differences in favor of tolrestat were observed for sensation in the toes as well as for pain (p < 0.05). These data indicate that withdrawal from long-term treatment with tolrestat has a detrimental effect on several measures of diabetic neuropathy, whereas continuation of treatment is associated with stabilization of these measures, suggesting a continued role for polyol pathway activity in late neuropathy.

引用

页码：170 / 178

页数：9

共 23 条

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