Evaluation of the Therapeutic Effect of Prostaglandin E1 on Diabetic Peripehral Neuropathy

A Multi-center Clinical Study

Abstract

It is believed that the pathogenesis of diabetic peripheral neuropathy involves a variety of factors including vascular disturbance and metabolic disorder.In the present study, we investigated the therapeutic effect of prostaglandin E1 (PGE₁) on diabetic peripheral neuropathy, since PGE₁ is known to exert blood flow increasing and anti-platelet aggregatory activities as well as a potent peripheral vasodilator activity.Fifty-three patients were given PGE₁ once daily by intravenous drip infusion in a dose ranging from 20 to 80μg.The treatment lasted for a period of 4 weeks as a rule.An improvement rate of over 80% was obtained in the subjective symptoms of diabetic peripheral neuropathy including spontaneous pain in the legs, hypesthesia and numbness.The motor nerve conduction velocity of the ulnar nerve was significantly improved at 4 weeks after treatment. A significant improvement in vibration sense was also observed at both 2 weeks and 4 weeks after treatment.However, no appreciable effect on the Achilles tendon reflex and patellar reflex was observed.The overall improvement rating, which was assessed on the basis of improvement of the subjective symptoms and nerve function tests, indicated an efficacy rate of 55% or 29 out of 53 cases.An assessment of usefulness rating demonstrated that PGE₁ was useful in 33 cases or 62%. The fasting blood sugar and HbA₁ levels slightly declined during the study, but this did not affect the therapeutic effect of PGE1.The above results suggest that PGE₁ is a useful drug for improvement of the subjective and objective symptoms of diabetic peripheral neuropathy.