Apfel S C, Kessler J A, Adornato B T, Litchy W J, Sanders C, Rask C A
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Neurology. 1998 Sep;51(3):695-702. doi: 10.1212/wnl.51.3.695.
Preclinical studies have demonstrated that nerve growth factor may prevent or reverse peripheral neuropathy. We have therefore tested the effects of recombinant human nerve growth factor in patients with diabetic polyneuropathy.
A total of 250 patients with symptomatic diabetic polyneuropathy randomly received either placebo or one of two doses of recombinant human nerve growth factor for 6 months. Patients were assessed for symptoms and signs of polyneuropathy before and after treatment.
Compared with placebo, recombinant human nerve growth factor led to significant improvement after 6 months of treatment, as measured by the sensory component of the neurologic examination, two quantitative sensory tests, and the impression of most subjects that their neuropathy had improved. Three prospectively identified multiple endpoint analyses indicated improvements in the nerve growth factor treatment groups over the placebo group in all three analyses (p = 0.032; p = 0.008; p = 0.005). Recombinant human nerve growth factor was well tolerated, with injection site discomfort reported as the most frequent adverse event.
Recombinant human nerve growth factor appears to be safe and shows preliminary evidence of efficacy in patients with symptomatic diabetic polyneuropathy.
临床前研究表明神经生长因子可能预防或逆转周围神经病变。因此,我们测试了重组人神经生长因子对糖尿病性多发性神经病变患者的影响。
总共250例有症状的糖尿病性多发性神经病变患者被随机给予安慰剂或两种剂量的重组人神经生长因子之一,治疗6个月。在治疗前后对患者进行多发性神经病变的症状和体征评估。
与安慰剂相比,经过6个月的治疗,重组人神经生长因子导致了显著改善,这通过神经学检查的感觉成分、两项定量感觉测试以及大多数受试者认为其神经病变有所改善的印象来衡量。三项前瞻性确定的多终点分析表明,在所有三项分析中,神经生长因子治疗组均比安慰剂组有所改善(p = 0.032;p = 0.008;p = 0.005)。重组人神经生长因子耐受性良好,注射部位不适被报告为最常见的不良事件。
重组人神经生长因子似乎是安全的,并且在有症状的糖尿病性多发性神经病变患者中显示出初步的疗效证据。