Epalrestat : une révolution silencieuse dans le traitement de la neuropathie diabétique périphérique ?

Details

Supervisors

Mouraux, André

Faculty

Faculté de pharmacie et des sciences biomédicales

Degree label

Master [120] en sciences pharmaceutiques, à finalité spécialisée

Abstract

enPeripheral diabetic neuropathy is one of the most frequent and disabling chronic complications of diabetes. It is characterized by neuropathic pain, progressive sensory disturbances, and a significant deterioration in quality of life. At present, management relies mainly on symptomatic treatments, with no proven effect on the underlying pathophysiological mechanisms responsible for nerve damage. In this context, epalrestat, an aldose reductase inhibitor, has attracted increasing interest due to its targeted action on the polyol pathway, which is involved in the development of diabetic neuropathy under conditions of chronic hyperglycemia. The aim of this thesis is to evaluate the role of epalrestat in the management of peripheral diabetic neuropathy through a systematic review of the literature. Based on the included clinical trials, the effects of epalrestat on sensory symptoms, electrophysiological parameters, metabolic biomarkers and quality of life are analyzed. The available data suggest an overall improvement in symptoms, in nerve conduction, as well as a favorable impact on certain pathophysiological markers. Some studies report non-significant results for specific parameters, mainly attributable to methodological limitations or insufficient follow-up durations. Overall, this work highlights the potential of epalrestat as a therapeutic approach targeting the underlying mechanisms of peripheral diabetic neuropathy, particularly when initiated at an early stage of the disease. It also emphasizes the need for further research to better define its place within current therapeutic strategies.