Effect of the Combination of Uridine Nucleotides, Folic Acid and Vitamin B12 on the Clinical Expression of Peripheral Neuropathies

SUMMARY: 

Aims: Peripheral neuropathy (PN) is a common condition whose incidence is approximately 8% in elderly persons. Neuropathic pain (NeP) has a significant incidence in the general population and affects more than half of all patients with PN. The pathophysiology of PN is characterized by lesions of myelin-producing Schwann cells in peripheral nerves. Regeneration/protection of the myelin sheath after a nerve lesion is a fundamental element of repair in PN. Nucleotides such as uridine monophosphate (UMP) have proven to be efficacious in treating the cause of the myelin sheath lesion in several experimental and clinical models. Our objective was to evaluate clinical improvement in patients with PN and NeP treated with a combination of UMP+folic acid+vitamin B₁₂ (Keltican^®). Patients and Methods: We performed an exploratory, open-label, multicenter, study of 212 patients followed for 2 months. Pain was assessed using the painDETECT questionnaire (PDQ). Results: The intensity of the NeP assessed at the time of the consultation progressed favorably and decreased significantly (p<0.001) in all the types of PN included. The global score for pain assessed using PDQ decreased from 17.5 points to 8.8 points at the final evaluation (p<0.001). Nonsteroidal anti-inflammatory drugs were decreased/withdrawn in 77.4% of patients. Conclusions: The combination of UMP+folic acid+vitamin B₁₂ is effective against NeP associated with PN. It leads to statistically significant reductions not only in the total PDQ score but also in the intensity of pain, number of areas affected, and pain radiation. Furthermore, it makes it possible to reduce the dosage of concomitant medication.

KEYWORDS:

• neuropathic pain
• nucleotides
• peripheral neuropathy
• uridine monophosphate

Acknowledgements

We are grateful to the following people: A Garcia and A Sanz (Ferrer, Portugal) for their participation in the writing of the manuscript; R Santos, L Magalhães and V Pinheiro (Ferrer, Portugal) for coordinating study monitoring; and P Baptista and N Gonçalves (KeyPoint, Portugal) for the evaluation and statistical report.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert t­estimony, grants or patents received or pending, or royalties.

Editorial assistance was provided by Content Ed Net.

Ethical conduct of research

The authors state that they have obtained appropriate insti­tutional review board approval or have followed the princi­ples outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investi­gations involving human subjects, informed consent has been obtained from the participants involved.