doiSerbia

The effect of benfothiamine in the therapy of diabetic polyneuropathy

Nikolić Ana (Institut za neurologiju, Klinički centar Srbije, Beograd)
Kačar Aleksandra (Institut za neurologiju, Klinički centar Srbije, Beograd)
Lavrnić Dragana (Institut za neurologiju, Klinički centar Srbije, Beograd)
Basta Ivana (Institut za neurologiju, Klinički centar Srbije, Beograd)
Apostolski Slobodan (Institut za neurologiju, Klinički centar Srbije, Beograd)

Introduction. Diabetic polyneuropathy (DPN) is one of the most common diabetic complications, which can result in a significant functional impairment and reduction of the quality of life in affected individuals. It occurs due to alterations in different biochemical mechanisms which require the presence of thiamine, which is why this vitamin is used in the therapy of DPN. Due to the low bioavailability of the hydrosolubile forms of thiamine, its liposolubile preparations (benfotiamine) are preferentially used. Objective. The aim of this study was to determine the efficacy of benfotiamine in combination with vitamin B6 in the therapy of DPN. Methods. The study group comprised of 22 patients with DPN who were treated with the combination of benfotiamine and vitamin B6 during 45 days. The effect of the therapy was evaluated by the analysis of different clinical, laboratory and electrophysiological parameters before and after conducted treatment. Results. After the treatment period, a statistically highly significant reduction of pain (p<0.01) was noted with the reduction of pain score on visual analogue scale in 86.4% of patients. A significant reduction of subjective complaints was also noted, with decreased modified total symptom score in 95.5% of patients (p<0.01). The presence of alodynia was reported at the beginning of the study in 77.3%, and after the benfotiamine therapy only in 22.7% of patients, while hyperpathy was initially present in 90.9%, and after treatment in 31.8% of patients (p<0,01). Neurophysiological parameters of polyneuropathy also significantly improved, with the improvement of the compound muscle action potential amplitude in 68.2% (p<0.01) and motor conduction velocity of the peroneal nerve in 45.5% of patients (p<0.01). The improvement of the sensory nerve action potential amplitude (p<0.01) and sensory conduction velocity (p=0.05) of the sural nerve was found in 45.5% of patients. After the treatment period, there was a highly statistically significant lowering of the glycosylated haemoglobin (p<0.01), with improved findings in 63.6% of patients. After completed study treatment protocol 86.4% of patients rated their overall condition as improved. Conclusion. Our results showed that the conducted treatment resulted in significant subjective and objective improvement of the disease signs symptoms, which confirmed that benfotiamine was good starting choice for the treatment of diabetic polyneuropathy.

Keywords: benfothiamine, polyneuropathy, diabetes mellitus, therapy