The efficacy of alpha-lipoic acid in migraine: A systematic review and meta-analysis

The Efficacy of Alpha-Lipoic Acid in Migraine: A Systematic Review and Meta-Analysis (P5-12.009)

ABSTRACTIntroduction:Male factors contribute to 30 to 50% of infertility in couples. Treatment options for male infertility are limited, so antioxidant supplementation for idiopathic male infertility is currently being studied. Alpha lipoic acid (ALA) has a high antioxidant capacity and the potential to penetrate tissues, cells, and organelles, including mitochondria, due to its water and lipid solubility properties. The recent inclusion of randomized trials in the literature has required a new systematic review and meta-analysis to evaluate the efficacy of alpha lipoic acid in sperm parameter changes.Purpose:We aimed to perform a systematic review and meta-analysis of the currently available randomized trials comparing the effects of ALA supplementation versus placebo on sperm function in infertile male patients.Material and Methods:Pubmed, Embase, Cochrane Library, and Scopus databases were searched from inception to June 2024. A random-effects model was employed to compute mean differences and risk ratios for continuous and binary endpoints. Heterogeneity was evaluated through the prediction interval. A sensitivity analysis was conducted by systematically excluding one study at a time and recalculating the pooled effect. All statistical analysis was conducted using R software 4.4.1. The certainty of evidence was evaluated with the GRADE approach. Results were reported following the PRISMA statement guidelines. This study was registered in PROSPERO.Results:Five randomized trials comprising 250 patients with a mean age of 28 to 40 years were included in this analysis. Over a mean follow-up time of 3 months, ALA was associated with a reduced proportion of abnormal sperm morphology (MD −0.89; 95% CI −1.48 to −0.29; p=0.003), increased total motility (MD 13.49; 95% CI 3.52 to 23.46; p=0.008), and increased sperm progressive motility (MD 12.43; 95% CI 2.89 to 21.97; p=0.01). Additionally, ALA was associated with a higher pregnancy rate in two individual studies reporting the outcome, however, no significance was found in our pooled analysis (RR 2.28; 95% CI 0.66 to 7.85; p=0.1). Finally, ALA did not change ejaculation volume (MD 0.14; 95% CI −0.54 to 0.83; p=0.6), sperm concentration (MD 11.99; 95% CI −0.67 to 24.66; p=0.06), live sperm (MD 4.42; 95% CI −3.17 to 12.02; p=0.2), or total antioxidant capacity (MD 0.43; 95% CI −0.02 to 0.87; p=0.06). No adverse events were reported.Conclusion:In this meta-analysis, ALA was associated with a favorable change in sperm quality. However, there were no effects on pregnancy rates. ALA should be considered for patients with idiopathic infertility.

Oxidative processes have been implicated in the pathogenesis of neurodegenerative dementias including Alzheimer's disease. Protecting the central nervous system against these damaging mechanisms may be a useful therapeutic approach. Alpha lipoic acid (ALA) is an endogenous antioxidant that interrupts cellular oxidative processes in both its oxidized and reduced forms. These properties might qualify ALA for a modulatory role in the treatment of people with dementia. To assess the role and clinical efficacy of alpha lipoic acid in the treatment of dementia. A search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG) on 3 February 2003 using the terms 'alpha lipoic acid' and 'thioctic'. The CDCIG Specialized register is updated regularly and contains records from all major health care databases (MEDLINE, EMBASE, PsycInfo, CINAHL) as well as from many trials databases. All double-blind randomized placebo-controlled trials examining the efficacy of alpha lipoic acid in dementia No trials were found that met the selection criteria No meta-analysis could be performed. A systematic search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group, as well as registers of ongoing and unpublished trials could not identify any studies investigating the use of ALA for dementia. In the absence of randomized double-blind placebo-controlled trials investigating ALA for dementia, no evidence exists to explore any potential effects. Until data from trials become available for analysis, ALA cannot be recommended for people with dementia.

To study the efficacy of alpha lipoic acid (ALA) in a group of patients with burning mouth syndrome (BMS). Sixty BMS patients, 30 treated with ALA (Thioderm) 800 mg day(-1) for 8 weeks and 30 patients on the same protocol with a placebo. The symptomatology was measured on a Visual Analogue Scale (VAS). Sixty patients (54 females and 6 males, mean age 64.37 +/- 11.61 years) were included. Thirty-nine patients completed the treatment (23 with ALA and 16 with a placebo). Reviews were carried out at 0, 1 and 2 months. No statistically significant differences were found in the average pre- and post-treatment values for pain with the VAS scores, obtained in the placebo (6.6 +/- 2.5 - 2.8 +/- 25 = 3.8 +/- 3.7) versus ALA (6.3 +/- 2.8 - 4.0 +/- 2.7 = 2.2 +/- 2.6). Only one patient pertaining to the group treated with ALA abandoned because of adverse gastrointestinal side effects. The results showed no significant differences between the two groups.

What still remains missing from participants’ selection criteria in clinical trials and systematic reviews?

Introduction Male factors contribute to 30 to 50% of infertility in couples. Treatment options for male infertility are limited, thus antioxidant supplementation for idiopathic male infertility is currently being studied. Alpha lipoic acid (ALA) has a high antioxidant capacity and the potential to penetrate tissues, cells and organelles, including mitochondria, due to its water and lipo solubility properties. The recent inclusion of randomized trials in the literature has required a new systematic review and meta-analysis to evaluate the efficacy of alpha lipoic acid in sperm parameters changes. Objective We aimed to perform a systematic review and meta-analysis of the currently available randomized trials comparing the effects of ALA supplementation versus placebo on sperm function in infertile male patients. Methods Pubmed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched from inception to June 2024. A random-effects model was employed to compute mean differences and risk ratios for continuous and binary endpoints. Heterogeneity was evaluated through the prediction interval. All statistical analysis was conducted using R software 4.4.1. The certainty of evidence was evaluated with the GRADE approach. Results were reported following the PRISMA statement guidelines. PROSPERO identification: CRD42024564932. Results Five randomized trials comprising 250 patients with a mean age of 28 to 40 years were included in this analysis. Over a mean follow-up time of 3 months, ALA was associated with a reduced proportion of abnormal sperm morphology (MD −0.89; 95% CI −1.48 to −0.29; p = 0.003), increased total motility (MD 13.49; 95% CI 3.52 to 23.46; p = 0.008), and increased sperm progressive motility (MD 12.43; 95% CI 2.89 to 21.97; p = 0.01). Additionally, ALA was associated with a higher pregnancy rate in two individual studies reporting the outcome, however, no significance was found in our pooled analysis (RR 2.28; 95% CI 0.66 to 7.85; p = 0.1). Finally, ALA did not change ejaculation volume (MD 0.14; 95% CI −0.54 to 0.83; p = 0.6), sperm concentration (MD 11.99; 95% CI −0.67 to 24.66; p = 0.06), live sperm (MD 4.42; 95% CI −3.17 to 12.02; p = 0.2), or total antioxidant capacity (MD 0.43; 95% CI −0.02 to 0.87; p = 0.06). No adverse events were reported. Conclusions In this meta-analysis of 5 studies, ALA was associated with a favorable change in sperm function. However, there were no effects on the pregnancy rates. This could be explained by the small sample size and short follow-up time. Therefore, more prospective randomized controlled trials are needed, especially including pregnancy rates and longer follow-up. Disclosure No.

Introduction: Exposure to nanomaterials (NPs) may lead to enhanced generation of free radicals and failure of endogenous antioxidant defense system ultimately resulting in oxidative stress. The present study aimed to evaluate the comparative efficacy of alpha lipoic acid (ALA) and quercetin, the two antioxidants against aluminium oxide nanoparticle induced oxidative stress. Methods and Materials: Male swiss albino mice were exposed to aluminum oxide NPs for seven days and were co-administered orally with quercetin and alpha lipoic acid (50 mg/kg each) to evaluate effects on heme synthesis pathway, hepatic oxidative injury and antioxidant potential. Results: The results suggest a significantly elevated ROS, decreased blood and hepatic GSH levels, Superoxide dismutase and Catalase activities after Al2O3 nanoparticles exposure. Co-administration of antioxidants increased GSH levels and was also beneficial in the recovery of oxidative injury and restoring inhibited ALAD activity. Conclusion: Our results suggest better efficacy of alpha lipoic acid than Quercetin in preventing appearance of toxic symptoms of following exposure to Al2O3 nanoparticles in mice.

Effectiveness of alpha lipoic acid supplementation on biochemical, clinical, and inflammatory parameters in patients with diabetic polyneuropathy: A systematic review and meta-analysis.

Burning mouth syndrome (BMS) is a chronic oral disorder of unknown etiology which presents therapeutic challenges. Alpha-lipoic acid (ALA) has been studied as a potential treatment for BMS. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of ALA compared to that of placebo or other interventions in individuals with BMS. Randomized controlled trials (RCT) using ALA to treat BMS were identified from MEDLINE, Cochrane Library, EMBASE, and Web of Science up to February 3, 2021. The assessment of the risk of bias in the included studies was based on the Cochrane guidelines. The primary outcome evaluated was the visual analog scale (VAS) pain intensity. ALA was compared with placebo, clonazepam, gabapentin, pregabalin, ALA plus gabapentin, capsaicin, Biotène®, and laser therapy. Altogether, 137 records were scanned for inclusion/exclusion, and nine RCTs (two unclear and seven at high risk of bias) were included in the qualitative and quantitative analyses, with a total of 594 patients with BMS included in this review. All studies reported an improvement in VAS pain scores ranging from -0.72 to -2.77. Meta-analysis results showed a non-significant reduction in pain intensity for ALA (P = 0.616) compared to that of placebo on a VAS of 0–10. Patients taking ALA were 1.923 times more likely to show an improvement in self-reported BMS symptoms (P = 0.031) than those in the placebo group. Clonazepam and pregabalin showed a significant VAS pain reduction of 4.08 and 4.68 (P < 0.001), respectively, compared to that with ALA. Although ALA intervention provided a non-significant improvement in the pain score and was more likely to produce a reduction in BMS symptoms, the evidence was of low quality. Further research is needed to establish clear guidelines for the use of ALA for BMS treatment.

AimTo evaluate the safety of four different dosages of alpha lipoic acid (400, 600, 800, and 1200 mg) as food supplement on adverse events related to alpha lipoic acid consumption and efficacy on glycemic status and lipid profile in subjects with euglycemia or dysglycemia.MethodsWe conducted a retrospective, observational study enrolling 322 patients, 83 taking 400 mg/day, 78 taking 600 mg/day, 80 taking 800 mg/day, and 81 taking 1200 mg/day alpha lipoic acid, respectively.ResultsIn the groups treated with alpha lipoic acid 800 and 1200 mg/day, we registered a reduction of FPG, TC, LDL-C, and Tg compared to baseline (p < 0.05 for all with alpha lipoic acid 800 mg/day, and p < 0.01 for all with alpha lipoic acid 1200 mg/day). The values recorded in the group treated with alpha lipoic acid 1200 mg/day were significantly lower compared to the ones obtained with alpha lipoic acid 400 mg/day. Moreover, alpha lipoic acid 1200 mg/day reduced Hs-CRP levels compared to baseline and compared to 400 mg/day (p < 0.05 for both). In the group treated with alpha lipoic acid at 800 mg/day, 5 subjects with IFG and 1 subject with IGT returned euglycemic. In the group treated with alpha lipoic acid at 1200 mg/day, 11 subjects with IFG and 3 subjects with IGT returned euglycemic. Adverse events of patients during alpha lipoic acid treatment included nausea, vomiting, dizziness, cutaneous rash, hypoglycemia, and hypotension. Adverse events did not differ among the four groups.ConclusionThe chronic use (4 years) of a food supplement containing alpha lipoic acid is well tolerated, without significant differences between lower and higher dosages and improves glycemic status and lipid profile but only if administered at high dosage.

Alpha-lipoic acid (ALA) is a naturally-occurring compound that has shown promising antioxidant and anti-inflammatory effects in experimental and human studies. The aim of this study was to assess the efficacy of ALA in the management of patients with diabetes mellitus (DM). We searched Medline (via PubMed), EBSCO, Scopus, and Web of Science for relevant randomized controlled trials. Data on glycated hemoglobin (HbA1c), blood glucose levels, lipid profile components, HOMA, and glutathione peroxidase (GPx) were extracted and pooled as the standardized mean difference (SMD) in a random effect model meta-analysis using RevMan version 5.3. Ten studies (n = 553 patients) were included. In the term of HBA1C, the overall SMD did not favor either of the two groups (SMD = 0.01, 95% CI [-0.32,0.35]; p = 0.94) in uncomplicated T2DM patients. Moreover, there was no statistically significant difference between the two groups in terms of FBG (SMD = -0.06, 95% CI [-0.44,0.33]; p = 0.78), PPBG (SMD = 0.04, 95% CI [-0.27,0.34]; p = 0.82), HDL (SMD = -0.05, 95% CI [-0.35,0.25]; p = 0.75), LDL (SMD = -0.05, 95% CI [-0.33,0.23]; p = 0.75). In terms of GPx, ALA was superior to placebo (SMD = 0.43, 95% CI [0.07,0.8]; p = 0.02). Our analysis showed that ALA was not superior to placebo in terms of HBA1C, LDL, HDL, TC, TG reduction in uncomplicated T2DM. However, in terms of GPx, ALA was significantly superior to the placebo. Further studies with larger sample sizes should investigate different doses of ALA in DM patients.

Oral submucous fibrosis (OSF) is a chronic irreversible condition of the oral mucosa with proven malignant potential. However, till date, there has been a dearth of effective management strategies. This study used alpha lipoic acid, an antioxidant, in oral form to determine if it could be useful in managing OSF patients. A case-control study was conducted on 18 patients of OSF (9 cases and 9 controls). The case group was treated using alpha lipoic acid in addition to the intralesional steroid and hyaluronidase injections used in the control group. The cases in the alpha lipoic acid group exhibited better relief of symptoms such as burning sensation of the mucosa and mouth opening, as compared to the controls. The use of alpha lipoic acid along with intralesional steroids and hyaluronidase caused reversal of higher clinical stages to lower ones. The use of an antioxidant, alpha lipoic acid, along with conventional therapy of intralesional steroid injections definitely seems to have a beneficial impact in the management of OSF.

Alpha Lipoic Acid (ALA) is a fatty acid that mainly synthases mammals and plants. Alpha lipoic acid is found in trace amounts, soluble in water and fat. ALA plays an essential role in the body's synthases of glutathione, the body's most important endogenous antioxidant, supporting healthy vision, protecting cells from free radicals, and enhancing liver functions. Additionally, ALA helps dissolve toxic substances in the liver. In the present review, we described the history with the physical and biochemical properties of ALA besides highlighting its functions in living organisms. We also reviewed the benefits of using synthetic forms of ALA in domestic animals to prevent and treat medical disorders. In conclusion, in addition to its role in enhancing body functions, ALA also plays a major role as a valuable antioxidant that could give an advantage to its use as a promising treatment against the widespread infection in animals and humans.

Objective: To evaluate the efficacy of alpha lipoic acid in the treatment of diabetic polyneuropathy focusing on sensory symptoms, nerve conduction velocity and H reflex in type 2 diabetes mellitus in patients at Hospital General IMSS Colima, Mexico. Background Diabetes mellitus can present neuropathy as a complication with an elevated risk for developing foot ulcers with subsequent amputation. Design/Methods: 100 diabetic patients presenting with symptomatic polyneuropathy were enrolled, in a randomized, double-blind, placebo-controlled study of a daily dosage of 1200mg of alpha lipoic acid n = 50 vs placebo n = 50 for 4 weeks. Main results were evaluated with Total Symptom Score TSS. Secondary results included nerve conduction velocity, individual symptom score, and H reflex. The above parameters were recorded at zero point, and; after treatment for 2, 4 weeks separately. Results: A total of 62 women and 38 men were included with a mean age of 53.9 years; a mean diabetes mellitus progression of 10 years. 50.27 patients with symptomatic polyneuropathy improved after treatment with alpha lipoic acid for 4 weeks vs 18.27 with placebo. TSS declined by 2.6 with alpha lipoic acid. And over 0.7 vs placebo P Conclusions: Oral treatment with Alpha lipoic acid for 4 weeks may improve symptoms in patients with diabetic polyneuropathy. A 600mg dosage, bid. for 4 weeks showed pronounced positive effects with little adverse. Disclosure: Dr. Millan-Guerrero has nothing to disclose. Dr. Garcia-Ramirez has nothing to disclose. Dr. Gonzalez-Perez has nothing to disclose. Dr. Millan-Guerrero has nothing to disclose. Dr. Isais-Millan has nothing to disclose. Dr. Castillo-Varela has nothing to disclose.

Objective: To compared efficacy of alpha lipoic acid (antioxidant medication) and aloe vera gel together versus intralesional steroids (hydrocortisone) in management of oral submucous fibrosis by evaluating post treatment clinical features of mouth opening and burning sensation.&#x0D; Study Design: A prospective comparative study.&#x0D; Place and Duration of Study: Department of ENT, Combined Military Hospital, Malir Karachi, from Jul 2018 to Mar 2020.&#x0D; Methodology: Twenty-eight patients were involved in the research and were distributed into two groups, I and II. Alpha lipoid acid with aloe vera gel was given in group I and hydrocortisone was given in group II. Burning sensation and mouth opening were recorded both at start and at monthly interval later on for three consecutive months. The data collected were statistically analyzed by using SPSS-22.&#x0D; Results: A significant lessening in burning sensation (p&lt;0.001) and improvement in mouth opening were noticed in both groups. However, comparison between alpha lipoic acid with aloe vera gel group versus hydrocortisone group showed almost similar results.&#x0D; Conclusion: Alpha lipoic acid and aloe vera gel can significantly improve oral submucous fibrosis clinically. So, these can be utilized as an alternative option in cases where intralesional steroid is poorly tolerated or is contraindicated.