Epalrestat, an aldose reductase inhibitor, in diabetic neuropathy: An Indian perspective

BACKGROUND: A number of diabetic patients with diabetic neuropathy, in India, were treated with epalrestat, an aldose reductase inhibitor. In this study, more than 2000 patients with diabetic neuropathy, who were treated with epalrestat for 3-12 months, were analyzed to assess the efficacy and the adverse reactions of the drug. METHOD: We analyzed the subjective symptoms (spontaneous pain, numbness, coldness and hypoesthesia) and the nerve function tests (motor nerve conduction velocity, sensory nerve conduction velocity and vibration threshold). RESULT: The improvement rate of the subjective symptoms was 75% (slightly improved or better) and that of the nerve function tests 36%. Adverse drug reactions were encountered in 52 (2.5%) of the 2190 patients, none of which was severe. CONCLUSION: Although data are limited, it is strongly suggested that epalrestat is a highly effective and safe agent for the treatment of diabetic neuropathy.