Morbidity and mortality of patients with diabetic neuropathy treated with pathogenetically oriented alpha-lipoic acid versus symptomatic pharmacotherapies - A nationwide database analysis from Hungary.

Abstract

AIMS:

Diabetic neuropathy is associated with increased risk of morbidity and all-cause mortality. It is unclear whether these outcomes differ in patients with diabetic neuropathy treated with pathogenetically oriented vs symptomatic pharmacotherapies.

METHODS:

We performed a retrospective (2009-2019) database analysis of patients treated with pathogenetically oriented alpha-lipoic acid (ALA) or symptomatic pharmacotherapies for diabetic neuropathy. We investigated clinical outcomes in propensity score matched patients in Hungary. Changes in hazard ratios and annualized event rates were assessed and sensitivity analyses performed.

RESULTS:

Hazard ratios favored treatment with ALA vs symptomatic pharmacotherapies regarding acute myocardial infarction (HR 0.73, 95% CI: 0.60-0.89, p = 0.0016), stroke (HR 0.71, 95% CI: 0.62-0.82, p < 0.0001), hospitalization for heart failure (HR 0.72, 95% CI: 0.66-0.78, p < 0.0001), cancer events (HR 0.83, 95% CI: 0.76-0.92, p = 0.0002) and all-cause mortality (HR 0.55, 95% CI: 0.49-0.61, p < 0.0001), but not for lower limb amputation (HR 1.05, 95% CI: 0.89-1.25, p = 0.5455). This association was supported by results of evaluating annual event rates and sensitivity analyses.

CONCLUSIONS:

This retrospective database analysis revealed a lower occurrence of cardio- and cerebrovascular morbidity, cancer events and all-cause mortality in patients with diabetic neuropathy treated with pathogenetically oriented ALA vs symptomatic pharmacotherapies. This hypothesis-generating result requires further investigations.

• Authors: György Jermendy, György Rokszin, Ibolya Fábián, Péter Kempler, István Wittmann
• Journal: Diabetes research and clinical practice (Diabetes Res Clin Pract) Vol. 201 Pg. 110734 (Jul 2023) ISSN: 1872-8227 [Electronic] Ireland
• PMID: 37257759 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Chemical References

• Thioctic Acid
• Antioxidants

Topics

• Humans
• Thioctic Acid (therapeutic use)
• Diabetic Neuropathies (drug therapy, epidemiology)
• Retrospective Studies
• Hungary (epidemiology)
• Antioxidants (therapeutic use)
• Diabetes Mellitus (drug therapy)