can lead to nerve damage that causes pain or numbness or
tingling in the legs or arms, but a new drug in
development looks like a promising treatment. The drug,
epalrestat, delays the progression of diabetic peripheral
neuropathy, as the condition is called, and
ameliorates its symptoms,
according to a report in the journal Diabetes Care.
Epalrestat is an aldose reductase inhibitor, a class of
compounds that have been developed to suppress a pathway
thought to be involved in diabetic neuropathy, the authors
explain, but most of these drugs have shown a weak benefit
or unacceptable side effects.
Dr. Nigishi Hotta from Chubu Rosai
Hospital, Nagoya, Japan
and colleagues studied the efficacy and long-term
safety of epalrestat in nearly 600 patients with mild
diabetic neuropathy. The subjects were randomly assigned
to the drug or to an inactive "placebo" for 3 years.
At follow-up, the epalrestat group showed no significant
deterioration in nerve conduction velocity or vibration
perception threshold, the team reports, whereas the
placebo group experienced significant deterioration in
both measures. After 3 years, the epalrestat group had
significantly less numbness of the upper and
lower extremities, hypersensitivity,
and cramping than did the control group, the researchers
note, though there were no significant differences in
There were no severe adverse events, the team reports, and
no adverse events were directly attributed to the
long-term administration of epalrestat. The researchers
noted that the benefits of long-term treatment with
epalrestat are particularly evident in patients with good
blood sugar control.