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This study was a 12-week, multi-center, randomized, double-blind, double dummy, parallel clinical trial to compare the efficacy of γ-linolenic acid and Thioctic acid in patients with diabetic neuropathy.
This study evaluated non-inferiority about the efficacy and safety of γ-linolenic acid (Evoprim soft capsule) through patients with diabetic neuropathy were compared γ-linolenic acid (Evoprim soft capsule) and Thioctic acid(LipoA HR Tab. 600mg) using double-blind, double dummy clinical trials. First outcome measures are Visual Analog Scale(VAS) and Total Symptom Score(TSS), secondary outcome measures are Michigan Neuropathy Screening Instrument(MNSI), Current perception Threshold(CPT), Modified Brief Pain Inventory-diabetic polyneuropathy(Modified BPI-DPN) and EuroQol-5 Dimensions(EQ 5D).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Test group | Experimental |
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| Control Group | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| γ-linoleic acid and placebo(Thioctic Acid) | Drug |
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| Measure | Description | Time Frame |
|---|---|---|
| Changes of Visual Analog Scale(VAS) | The Visual Analog Scale(VAS) score is 0 point for no symptom, 10 points for the most severe symptom, and the patient is asked to mark the degree of subjective pain symptoms as an integer. | 12 weeks |
| Changes of Total Symptom Score(TSS) | Total Symptom Score(TSS) classifies diabetic neuropathy symptoms into four categories (pain, burning pain, paresthesia, numbness). The frequency (Occasional, Frequent, Continuous) and symptom intensity (Absent, Slight, Moderate, Severe) are calculated through each question and the score is obtained according to the visual analog scale. It is calculated from 0 point up to 14.64 points. | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Changes of Michigan Neuropathy Screening Instrument(MNSIQ) | A 15-item questionnaire (MNSIQ) is used to assess deformation, infection, skin thickening of the skin's stratum corneum, and ulcers. MNSIQ was designed to screen for diabetic neuropathy through questionnaires on 15 questions that are related to neuropathic symptoms (pain, temperature, and sensation). Two of 15 (number 4 and 10) are vascular symptoms and are excluded from the total score regardless of the results. If you answered 'No' to questions 7 and 13, you will get 1 point. In the end, scores ranging from 0 to 13 indicate that the higher the score, the more severe the neuropathic symptoms. |
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Inclusion Criteria:
Patients who were between 20 years and 75 years at screening
Patients who were diagnosed with type 2 diabetes and whose HbA1c levels were less than 11% at screening
Patients with a score of 4 or more on the Visual Analogue Score(VAS)
One or more of the following items
Patients who decided to voluntarily participate in clinical trials and agreed in writing
Exclusion Criteria:
Peripheral neuropathy caused by other causes other than diabetes
Those are suffering from other painful conditions that are so severe that diabetic neuropathy can not be assessed
If you have a progressive or degenerative neurological disorder
Patients with a systolic blood pressure(SBP)≥ 160 mmHg or ≤ 100 mmHg or a diastolic blood pressure(DBP) ≥ 95 mmHg or ≤ 60 mmHg
Patients who were positive for human immunodeficiency virus (HIV), hepatitis B (HBV), or hepatitis C (HCV) test
patients with liver dysfunction (ALT / AST> 3 times the upper limit of normal)
Patients with renal dysfunction (Serum creatine> 2.0 mg / dl)
Patients with thyroid dysfunction (Thyroid and anti-thyroid medications may be included in this study if they are maintained in normal state.)
Patients with amputation (including toes) or infections of the lower extremities
The following diseases are clinically significant patients
Patients who have suicide attempts or suicidal tendencies and who have a psychiatric history within 6 months before starting the trial
Patients with substance abuse or chronic alcohol abuse within 2 years prior to taking the test
Patients who received intravenous steroid injection or topical anesthetic injection within 2 months before participating in the study
Patients who participated in other studies within 4 weeks before participating in the trial, or who are currently taking medication for other research
Screening After randomization for 2 weeks (pause period) before screening, antipsychotics, antipsychotics, sleep depressants, antidepressants, antiepileptics, muscle relaxants, analgesics (narcotic analgesics, NSAIDs, tramadol etc.) Patients who received capsaicin or who received percutaneous electrical nerve stimulation therapy (TENS) or acupuncture
Patients with a history of hypersensitivity or clinically significant hypersensitivity reactions to this drug substance and soybean oil, soy or peanut
Patients with clinically significant skin disease or severe skin irritability
Pregnant or lactating women
patients suffering from schizophrenia or those who are treated with chloropromazine, mesoridazine, thioridazine, fluphenazine, perphenazine, trifluoperazine, haloperidol (haloperidol), loxapine (loxapine) and other drugs known to cause epileptic seizures
In addition to the above items, patients who are deemed inappropriate by clinical trial researchers
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| Name | Affiliation | Role |
|---|---|---|
| Bong-Yeon Cha, MD,PhD | The Catholic University of Korea | Principal Investigator |
| Jong hwa Kim, MD | Sejong General Hospital | Principal Investigator |
| Lee-byeong Park, MD,PhD | Gachon University Gil Medical Center | Principal Investigator |
| Hyuk Sang Kwon, MD,PhD | The catholic university of korea Yeouido st. mary's hospital | Principal Investigator |
| In Joo Kim, MD,PhD | Pusan National University Hospital | Principal Investigator |
| Ji hyun Lee, MD,PhD | Daegu Catholic University Medical Center | Principal Investigator |
| sung soo Moon, MD,PhD | DongGuk University | Principal Investigator |
| Sung wan Chun, MD,PhD | Soon Chun Hyang University | Principal Investigator |
| Byung-Wan Lee, MD,PhD | Yonsei univesity severance hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sejong hospital | Bucheon-si | Gyeonggi-do | 14754 | South Korea | ||
| Obesity Research Center of Chonbuk National University |
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| Thioctic Acid and placebo(γ-linoleic acid) | Drug |
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| 12 weeks |
| Changes of Michigan Neuropathy Screening Instrument(MNSIE) | A foot test (MNSIE) is used to assess deformation, infection, skin thickening of the skin's stratum corneum, and ulcers. MNSIE evaluates foot shape, foot ulceration, ankle reflex, sense of vibration of big toe, monofilament right and left. The score ranges from point 0 to 10, and when the score is above 2, it is diagnosed as neuropathy. | 12 weeks |
| Changes of Current perception Threshold(CPT) | Sensory nerve conduction threshold (SNCT) is a unique method for evaluating all three sensory neurons (small unmyelinated fibers, small myelinated fibers, and large myelinated fibers) that make up more than 90% of sensory nerves. It seems to be possible to objectively evaluate sensory nerve of small fiber which recovered early in diabetic neuropathy(Using neurometer). | 12 weeks |
| Changes of Modified Brief Pain Inventory-diabetic polyneuropathy(Modified BPI-DPN) | Modified Brief Pain Inventory-diabetic polyneuropathy(Modified BPI-DPN) displays the pain area on the human figure, the number of pain sites, treatment of pain, and pain medication. Pain severity refers to the pain sensation- identification aspect (pain threshold). The worst pain, the least pain, the pain average, and the pain now for the last 24 hours are displayed on the 10-point scale (0 points: none, ~ 10 Point: too big to imagine). Pain interference is the emotional-synchronous aspect of pain (pain tolerance). It classifies general activity, mood, walking, working, relationship, sleep and enjoyment of life, and use the 10-point scale (0 points: none to 10 points: completely disturbed). | 12 weeks |
| Changes of EuroQol-5 Dimensions(EQ 5D) | EQ-5D index = 1 - (0.050 + 0.096 M2 + 0.418 x M3 + 0.046 x SC2 + 0.13 x SC3 + 0.051 x UA2 + 0.028 x UA3 + 0.037 x PD2 + 0.151 x PD3 + 0.043 x AD2 + 0.158 x AD3 + 0.050 × N3) - 1 if the variable is applicable, 0 if not (M: mobility, SC: self-care, UA: usual activity,, PD: pain / discomfort, AD: anxiety / depression) * Variable definition
| 12 weeks |
| Jong chul Won, MD,PhD | Inje University | Principal Investigator |
| Tae-Sun Park, MD,PhD | Chonbuk National University Hospital | Principal Investigator |
| Jeonju |
| Jeollabuk-do |
| 54907 |
| South Korea |
| Dongguk university gyeongju hospital | Gyeongju | North Gyeongsang-do | 38067 | South Korea |
| Soon chun hyang university hospital cheonan | Cheonan | South Chungcheong Province | 31151 | South Korea |
| Daegu Catholic University Medical Center | Daegu | 42472 | South Korea |
| Gachon University Gil Medical Center | Incheon | 2156 | South Korea |
| Pusan National University Hospital | Pusan | 49241 | South Korea |
| Inje university sanggye paik hospital | Seoul | 01757 | South Korea |
| Yonsei univesity severance hospital | Seoul | 03722 | South Korea |
| The catholic university of korea seoul st. mary's hospital | Seoul | 06591 | South Korea |
| The catholic university of korea Yeouido st. mary's hospital | Seoul | 07345 | South Korea |
| ID | Term |
|---|---|
| D003929 | Diabetic Neuropathies |
| ID | Term |
|---|---|
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D008063 | Thioctic Acid |
| ID | Term |
|---|---|
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
| D013876 | Thiophenes |
| D013457 | Sulfur Compounds |
| D003067 | Coenzymes |
| D045762 | Enzymes and Coenzymes |
| D005227 | Fatty Acids |
| D008055 | Lipids |
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