Epalrestat For Diabetic Peripheral Neuropathy: A Systematic Review

Objective To assess the efficacy and safety of Epalrestat for diabetic peripheral neuropathy(DPN).Methods We searched PubMed,the Cochrane Library,EMbase,OVID, CBM,CNKI,VIP,Wanfang Data.Randomized controlled trials(RCT)of clinical therapeutic studies on Epalrestat for diabetic peripheral neuropathy were included.The quality of included studies was evaluated on the basis of the inclusion criteria and the exclusion criteria.Meta-analysis was performed according to the data and its results were assessed by sensitivity analysis and bias analysis.Result Fourteen trials involving 1513 participants with DPN were included. There were 744 participants in treatment group and 769 participants in control group(which included 420 participants in Placebo group and 349 participants in Mecobalamin group).Meta-analysis indicated that Epalrestat was more effective than Placebo in improving symptoms and median motor nerve conduction velocity of DPN.The effect sizes were[RR=1.14,95%CI(1.02,1.28)],[WMD=1.62,95%CI(0.94,2.30)]respectively.Epalrestat was more effective than Mecobalarnin in improving peroneal motor nerve conduction velocity [WMD=4.59,95%CI(0.24,8.94)].But it was not statistically significant in improving symptoms of DPN,median motor nerve conduction velocity,median sensory nerve conduction velocity,peroneal sensory nerve conduction velocity compared with Mecobalamin.Slight adverse effects were reported in 9 studies. It suggested that Epalrestat was safe.Conclusion Epalrestat is effective in improving symptoms of DPN and the effect in improving motor nerve conduction velocity is more evident than sensory nerve conduction velocity.And the therapeutic effect is similar with Mecobalamin.No severe adverse effects were reported.