The Benefits of Astaxanthin as Add on Therapy in the Management of Painful Diabetic Neuropathy Patient

NCT ID: NCT04689984

Last Updated: 2020-12-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-03

Study Completion Date

2021-11-30

Brief Summary

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Diabetes is one of the main health care problemsworldwide with 5% average increased number of cases every year. According to International Diabetes Federation the prevalence of people with diabetes reached the number of 425 million people in 2017 and estimated rising to 628 million by 2045. Painful Diabetic Neuropathy (PDN) is the most common complication of diabetes affecting 90% of the patients. The symptoms of PDN include numbness, burning, stabbing pain, paraesthesia or hyperesthesiaof both symmetrical limbthat could reduce the quality of life. Several studies have found several therapeutic options to cope with pain in the PDN, but the results are not as satisfactory due to the uncertain pathophysiology of the disease and the limitations of the drug that can be administered because of itspolypharmaceutical side effects. The causes of diabetic neuropathy not only include vascular and metabolic factors but also Reactive Oxygen Species.

There are several therapeutic options that can be administered such as glycemic index arrangement,foot care, symptomatic treatment, and predominantly pain therapy. According to guidelines, there are drugs therapy thatrecommended for PDN, among others, Gabapentin, Pregabalin and anticonvulsants until the pain subsides. Unfortunately, this treatment is only aimed at relieving the symptoms of existing pain but not working on existing pathophysiological mechanisms and fixing sensory deficits of neuropathy trials. Multi-target treatments is needed to attenuate neuronal inflammation, oxidative stress and apoptosis. Additional therapy can be an option to support healing and also the process of metabolic pathophysiology that occurs due to rising glycemic index in the body that causes the work of hexosamine pathway and trigger the formation of ROS and inflammation. There is evidence of research demonstrating the neuroprotective effects of Astaxanthin as oxidative, anti-inflammatory and anti-apoptotic agent. Not only that, Astaxanthin is also a good supplement addition with no toxic effects when consumed, as well as hydrophilic and also lipophilic nature which makes Astaxanthin can penetrate the BBB effectively.

Detailed Description

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Detailed Description:

This was randomized clinical trial, active comparator, open label, controlled study from the period of November 2020 - November 2021 at Bethesda Hospital, Yogyakarta, Indonesia.

There were 60 painful diabetic neuropathy patients who fulfilled the inclusion and exclusion criteria. Each subject had been followed up from the first day of medication administration until 8 weeks after medication administration.

Ethical approval number ((kosong)) was obtained from Health Research Ethics Committee, Bethesda Hospital Yogyakarta.

The hypothesis of this study:

a. Add on oral astaxanthin to standard treatment in patients with painful diabetic neuropathy is more effective in reducing pain and neuropathic symptoms in 8 weeks of treatment compared with standard treatment, b. Add on oral astaxanthin to standard treatment in patients with painful diabetic neuropathy is as safe as standard treatment.

Conditions

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Painful Diabetic Neuropathy

Keywords

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Astaxanthin Standard therapy Neuropathy Diabetic neuropathy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Eligible subjects were randomly allocated to receive any of the following regiments: standard therapy consists of pregabalin, gabapentine, or amitriptyline (control group) or standard therapy and astaxanthin 6 mg tablet once daily (experimental group).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Open label

Study Groups

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Experimental Group

Receive standard therapy consists of gabapentin, pregabalin, or amitriptyline and astaxanthin 6 mg tablet once daily (experimental group).

Group Type EXPERIMENTAL

Standard therapy

Intervention Type DRUG

Gabapentin, pregabalin, or amitriptyline

Astaxanthin

Intervention Type DRUG

Astaxanthin 6 mg tablet once daily

Control Group

Receive standard therapy consists of gabapentin, pregabalin, or amitriptyline.

Group Type ACTIVE_COMPARATOR

Standard therapy

Intervention Type DRUG

Gabapentin, pregabalin, or amitriptyline

Interventions

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Standard therapy

Gabapentin, pregabalin, or amitriptyline

Intervention Type DRUG

Astaxanthin

Astaxanthin 6 mg tablet once daily

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Male or female
* Adult age (\>18 years old)
* Diagnosed as painful diabetic neuropathy based on validated Diabetic Neuropathy Symptoms (DNS) and Diabetic Neuropathy Examination (DNE)

Exclusion Criteria

* Subjects with significant renal and liver problem
* Subjects with known hypersensitivity to astaxanthin
* Pregnancy and breastfeeding patients
* Patients that enrolled any clinical trial within a month
* Not competent enough in giving approval and answering questionnaires
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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PT SOHO Global Health Tbk

UNKNOWN

Sponsor Role collaborator

Duta Wacana Christian University

OTHER

Sponsor Role lead

Responsible Party

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Rizaldy Taslim Pinzon

Principal investigator, Neurologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rizaldy T Pinzon, MD, MSc, PhD

Role: PRINCIPAL_INVESTIGATOR

Duta Wacana Christian University

Locations

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Bethesda Hospital Yogyakarta

Yogyakarta, Special Region of Yogyakarta, Indonesia

Site Status RECRUITING

Countries

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Indonesia

Central Contacts

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Rizaldy T Pinzon, MD, MSc, PhD

Role: CONTACT

Phone: +62 81294638229

Email: [email protected]

Vanessa Veronica, BM

Role: CONTACT

Phone: +62 89605559529

Email: [email protected]

Facility Contacts

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Rizaldy T Pinzon, MD, MSc, PhD

Role: primary

References

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Fakhri S, Aneva IY, Farzaei MH, Sobarzo-Sanchez E. The Neuroprotective Effects of Astaxanthin: Therapeutic Targets and Clinical Perspective. Molecules. 2019 Jul 20;24(14):2640. doi: 10.3390/molecules24142640.

Reference Type BACKGROUND
PMID: 31330843 (View on PubMed)

Iqbal Z, Azmi S, Yadav R, Ferdousi M, Kumar M, Cuthbertson DJ, Lim J, Malik RA, Alam U. Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and Pharmacotherapy. Clin Ther. 2018 Jun;40(6):828-849. doi: 10.1016/j.clinthera.2018.04.001. Epub 2018 Apr 30.

Reference Type BACKGROUND
PMID: 29709457 (View on PubMed)

Javed S, Alam U, Malik RA. Treating Diabetic Neuropathy: Present Strategies and Emerging Solutions. Rev Diabet Stud. 2015 Spring-Summer;12(1-2):63-83. doi: 10.1900/RDS.2015.12.63. Epub 2015 Aug 10.

Reference Type BACKGROUND
PMID: 26676662 (View on PubMed)

Juster-Switlyk K, Smith AG. Updates in diabetic peripheral neuropathy. F1000Res. 2016 Apr 25;5:F1000 Faculty Rev-738. doi: 10.12688/f1000research.7898.1. eCollection 2016.

Reference Type BACKGROUND
PMID: 27158461 (View on PubMed)

Kaur S, Pandhi P, Dutta P. Painful diabetic neuropathy: an update. Ann Neurosci. 2011 Oct;18(4):168-75. doi: 10.5214/ans.0972-7531.1118409.

Reference Type BACKGROUND
PMID: 25205950 (View on PubMed)

Rosenberger DC, Blechschmidt V, Timmerman H, Wolff A, Treede RD. Challenges of neuropathic pain: focus on diabetic neuropathy. J Neural Transm (Vienna). 2020 Apr;127(4):589-624. doi: 10.1007/s00702-020-02145-7. Epub 2020 Feb 8.

Reference Type BACKGROUND
PMID: 32036431 (View on PubMed)

Schreiber AK, Nones CF, Reis RC, Chichorro JG, Cunha JM. Diabetic neuropathic pain: Physiopathology and treatment. World J Diabetes. 2015 Apr 15;6(3):432-44. doi: 10.4239/wjd.v6.i3.432.

Reference Type BACKGROUND
PMID: 25897354 (View on PubMed)

Snyder MJ, Gibbs LM, Lindsay TJ. Treating Painful Diabetic Peripheral Neuropathy: An Update. Am Fam Physician. 2016 Aug 1;94(3):227-34.

Reference Type BACKGROUND
PMID: 27479625 (View on PubMed)

Wu H, Niu H, Shao A, Wu C, Dixon BJ, Zhang J, Yang S, Wang Y. Astaxanthin as a Potential Neuroprotective Agent for Neurological Diseases. Mar Drugs. 2015 Sep 11;13(9):5750-66. doi: 10.3390/md13095750.

Reference Type BACKGROUND
PMID: 26378548 (View on PubMed)

Other Identifiers

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ASTAXANTHIN

Identifier Type: -

Identifier Source: org_study_id