The time to develop treatments for diabetic neuropathy

BACKGROUND: Diabetic neuropathy is a multifaceted condition affecting up to 50% of individuals with long standing diabetes. The most common presentation is peripheral diabetic sensory neuropathy (DPN).

METHODS: We carried out a systematic review of papers dealing with diabetic neuropathy on Pubmed in addition to a targeted Google search.Search terms included small fiber neuropathy,diffuse peripheral neuropathy, quantitative sensory testing, nerve conduction testing, intra-epidermal nerve fiber density, corneal confocal reflectance microscopy, aldose reductase inhbitors, nerve growth factor, alpha-lipoic acid, ruboxistaurin, nerve growth factor antibody, and cibinetide.

RESULTS: Over the past half century, there have been a number of agents undergoing unsuccessful trials for treatment of DPN.There are several approved agents for relief of pain caused by diabetic neuropathy, but these do not affect the pathologic process.

EXPERT OPINION: The failure to find treatments for diabetic neuropathy can be ascribed to (1) the complexity of design of studies and (2) the slow progression of the condition, necessitating long duration trials to prove efficacy.We propose a modification of the regulatory process to permit early introduction of agents with demonstrated safety and suggestion of benefit as well as prolongation of marketing exclusivity while long term trials are in progress to prove efficacy.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:30

Enthalten in:

Expert opinion on investigational drugs - 30(2021), 2 vom: 19. Feb., Seite 119-130

Sprache:

Englisch

Beteiligte Personen:

Rendell, Marc S [VerfasserIn]

Links:

Volltext

Themen:

Aldose reductase inhibitors
Diabetic neuropathy
Intraepidermal nerve fibers
Journal Article
Nerve conduction testing
Nerve growth factor
Peripheral Nervous System Agents
Quantitative sensory testing
Systematic Review

Anmerkungen:

Date Completed 17.02.2021

Date Revised 20.04.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/13543784.2021.1868433

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM31987074X