Treatment of chronic painful diabetic neuropathy with isosorbide dinitrate spray: a double-blind placebo-controlled cross-over study

摘要: OBJECTIVE —Considerable evidence implicates impaired nitric oxide (NO) generation in the pathogenesis of diabetic neuropathic pain. We therefore conducted a pilot study to examine effects isosorbide dinitrate (ISDN), NO donor with local vasodilating properties, spray form management chronic RESEARCH DESIGN AND METHODS —The was double-blind, randomized, placebo-controlled, and two-period cross-over design. After 2-week run-in period, 22 patients (13 men, 20 type 2 diabetes, age [mean ± SE] 63.7 1.8 years, duration diabetes 9.1 1.5 painful neuropathy 2.6 0.4 years) were randomized receive ISDN or placebo sprays for 4 weeks, exchanging their treatment further weeks after wash-out period. The administered both feet before bedtime. Biweekly pain other sensory symptoms assessed using visual analog scale (VAS) Lickert scale, respectively. RESULTS —ISDN reduced overall ( P = 0.02) burning sensation 0.006). No difference observed modalities (hot/cold sensation, tingling, numbness, hyperesthesia, jabbing-like sensation). At completion, 11 (50%) reported benefit wished continue spray, (18%) preferred remaining 7 (32%) undecided. CONCLUSIONS offers an alternative effective pharmacological option relieving neuropathy. potential alleviating specific associated peripheral merits study.