Effect of epalrestat on diabetic peripheral neuropathy: a randomized placebo-controlled trails Meta-analysis

Objective To assess the effect and safety of epalrestat on diabetic peripheral neuropathy(DPN). Methods Retrieved from PubMed, Cochrane Library, CNKI, VIP, CBM and Wanfang database, RCTs about epalrestat in the treatment of DPN were included from establishment to July 2017 and comprehensively evaluated. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, assessed the risk bias of included studies, and then analysis was performed using the RevMan 5.3 software. Results A total of 14 RCTs involved 1 945 patients were included. The results of systematic review and Meta-analysis showed that epalrestat could significantly improve DPN compared with the placebo/blank control group(OR=8.01, 95%CI: 4.48-14.32, P<0.01; OR=2.49, 95%CI: 1.71-3.65, P<0.01). Compared with the placebo group and the blank control group, epalrestat could significantly improve the median sensory nerve conduction velocity(OR=3.92, 95%Cl: 1.37-6.47, P<0.01), peroneal nerve conduction velocity(OR=4.87, 95%CI: 2.35-7.39, P<0.01) and ulnar nerve conduction velocity(OR=4.58, 95%CI: 2.54-6.63, P<0.01). The major adverse reactions were gastrointestinal reactions, nausea and vomiting, but no serious adverse reactions were observed in the epalrestat group, compared with the placebo/blank control group, the difference was statistically significant(OR=12.87, 95%CI: 2.35-70.50, P<0.01). Conclusion Epalrestat can effectively treat DPN through improving the body's sensory nerve conduction velocity, and it has no serious adverse reactions. Since the limitation of quality and quantity of included studies, large-scale and high-quality randomized double-blinding controlled trails are needed to verify the above conclusion. Key words: Epalrestat; Diabetic neuropathies; Randomized controlled trial; Meta-analysis