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September 28, 2007Diabetes CareOpen Access

Factors That Impact Symptomatic Diabetic Peripheral Neuropathy in Placebo-Administered Patients From Two 1-Year Clinical Trials

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Key result

Placebo improves mild diabetic neuropathy symptoms despite declining nerve conduction and heart rate deep breathing.

  • n=262

Why the study?

How do neuropathy symptoms and disease progression change over 1 year in placebo-administered patients with mild diabetic peripheral neuropathy?

Population

262 placebo-administered patients with mild diabetic peripheral neuropathy from two identical phase 3…

Design

Cohort, double-blind (in original trials)

Follow-up

1 year

Authors

STSolomon TesfayeSemmelweis UniversityRTRup TandanUniversity of VermontEBEdward J. BastyrEli Lilly (United States)

Discussion

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Implication

Symptom improvement despite objective decline in mild DPN may reflect placebo effects; leaves open optimal endpoints for future progression trials.

Study Design

Type

RCT (n=262)

Blinding

double-blind

Randomization

randomized

Structured PICO

How do neuropathy symptoms and disease progression change over 1 year in placebo-administered patients with mild diabetic peripheral neuropathy?

P
Population
262 placebo-administered patients with mild diabetic peripheral neuropathy from two 1-year phase 3 trials.
I
Intervention
Placebo
O
Outcome
Change in neuropathy symptoms and disease progression (including neuropathy impairment score of lower limbs [NIS(LL)], vibration detection threshold [VDT], Neuropathy Total Symptom Score-6 [NTSS-6], electrophysiology measures, and heart rate deep breathing [HRDB]) at 1 yearpatient reported

In placebo-treated patients with mild symptomatic DPN, symptoms progressively improve over 12 months despite declines in objective measures like nerve conduction and heart rate deep breathing.

Limitations

  • Clinically significant worsening of DPN would require > 1 year of observation

Cite This Study

Tesfaye et al. (2007) conducted an RCT in mild diabetic peripheral neuropathy (n=262). Ruboxistaurin (RBX) vs. Placebo was evaluated on Change in neuropathy symptoms and disease progression. In placebo-administered patients with mild diabetic peripheral neuropathy, symptoms improved over 1 year (NTSS-6 -3.73; P<0.001), whereas nerve conduction and heart rate deep breathing declined.

synapsesocial.com/papers/6aa882f42d13cdf8fa59b345https://doi.org/10.2337/dc07-0608
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Also Consider

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  1. 1Neuropathy Among the Diabetes Control and Complications Trial Cohort 8 Years After Trial Completion2006 · 350 citations
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  4. 4The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population‐based cohort1993 · 1,491 citations
  5. 5Monotonicity of Nerve Tests in Diabetes2005 · 76 citations