Research Article
Volume 7 Issue 1 - 2021
Evaluation of the Efficacy of an Association of Uridine Monophosphate, Folic Acid and Vitamin B12 in the Treatment of Pain in Patients with Diabetic Peripheral Neuropathy
Negrão Luis1*, Almeida Luis2, Álvarez Miguel Angel3, Blanco Belén4, Faria Igor5, Lage Nicole6 and Lopes Cátia7
1Neuromuscular Disease Unit, Neurology Service, CHUC, Coimbra, Portugal
2UCSO Viana do Castelo, Viana do Castelo, Portugal
3USF Cuidarte, Viana do Castelo, Portugal
4USF Uarcos, Arcos de Valdevez, Portugal
5USF Gil Eanes, Viana do Castelo, Portugal
6USF Lethes, Ponte de Lima, Portugal
7USF Mais Saúde, Ponte de Lima, Portugal
*Corresponding Author: Negrão Luis, Neuromuscular Disease Unit, Neurology Service, CHUC, Coimbra, Portugal.
Received: September 28, 2020; Published: September 21, 2021




Abstract

Background: Diabetes mellitus is the most common cause of peripheral neuropathy (PN). About half of diabetic patients are affected by this condition, and up to 15 - 25% of them suffer from neuropathic pain. Pyrimidine nucleotides, like cytidine and uridine, have proven efficacious in the treatment of peripheral nerve lesions, palliate the pain and enhancing the neuroregenerative effect.

Aim and Method: An open-label, exploratory, multicentre study was conducted in Portugal to evaluate the effectiveness and safety of a food supplement as Keltican® in patients with painful diabetic peripheral neuropathy (PDPN) in primary care. Patients were treated with 2 capsules of Keltican® (uridine monophosphate (UMP, 50 mg), folic acid (400 μg) and vitamin B12 (3 μg)) per day for the first two weeks, and one capsule per day in the remaining 6 weeks. Decrease of the intense pain felt in the 24 hours before visits was evaluated by Visual Analogic Scale of pain (VAS). Additional qualitative aspects of pain and its evolution were assessed using the Short-form McGill Pain Questionnaire (SF-MPQ), the Present Pain Intensity (PPI) Scale, the Clinical Global Impression-Severity Scale (CGI-S) and the Karolinska Sleepiness Scale (KSS).

Results: 42 patients were included. There was a reduction of the VAS score from 5,4 ± 1,6 to 3,4 ± 1,7 after 60 days of the treatment administration (p < 0,0001 [-2,5; -1,5]). An 83,3% (35/42) of the patients reported a reduction of the VAS score after 60 days of treatment administration. A significant improvement was also observed in secondary variables of pain (PPI, KKS and CGI-S) between baseline and final values. A statistically significant improvement was registered in the sensorial dimension of pain (SF-MPQ), specially dysesthesia, needle pain and continuous pain, being 0,7, 0,6 and 0,5, respectively.

Discussion: Patients treated with a combination of uridine nucleotides with folic acid and vitamin B12 could relief the pain associated to peripheral diabetic neuropathy as well as decreasing the necessity of concomitant pain killers, without major safety concerns. A randomised placebo-controlled trial with electromyographic evaluation should be performed in order to corroborate the results presented.

Keywords: Diabetic Peripheral Neuropathy; Nucleotides; Neuropathic Pain; Primary Care

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Citation: Negrão Luis., et al. “Evaluation of the Efficacy of an Association of Uridine Monophosphate, Folic Acid and Vitamin B12 in the Treatment of Pain in Patients with Diabetic Peripheral Neuropathy”. EC Anaesthesia 7.1 (2021): 01-09.

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