Oleh Admin Kalbe Medical pada May 11, 2018 07:30

Sodium Valproate Efektif untuk Nyeri Neuropatik Diabetikum

Nyeri neuropatik diabetikum terjadi karena adanya disfungsi saraf perifer dengan penyebab yang meliputi rendahnya kontrol indeks glikemik dan durasi penyakit serta beberapa faktor lainnya seperti hipertensi, usia, merokok, hiperinsulinemia, dan dislipidemia. Hal ini perlu diperhatikan karena pengaruhnya terhadap kualitas hidup pasien. Pemberian obat seperti NSAID, anti-depresi, dan anti-epilepsi sudah ada namun, masih terdapat masalah terkait efek samping dan kontraindikasinya. Sodium valproate merupakan obat yang efektif pada kasus trigeminal neuralgia dan profilaksis migrain, juga menunjukkan peranan yang signifikan pada kasus neuropatik diabetikum yang sangat nyeri, dengan toksisitas rendah dan efek samping yang lebih dapat ditoleransi.

Kochar DK, et al, melakukan studi acak, tersamar ganda, dan terkontrol plasebo, pada 39 pasien dengan nyeri neuropatik diabetikum yang berdurasi minimal 6 bulan dengan stabilitas dosis insulin atau anti-diabetik oral serta memiliki alasan kontrol diabetik (HbA1c<11) di mana nyeri neuropatik harian minimal derajat sedang-berat selama >3 bulan di sela-sela aktivitas harian dan/ atau saat tidur. Sebanyak 39 pasien ini dibagi ke dalam 2 kelompok, dengan kelompok I (21 pasien) diberikan dosis sodium valproate dan kelompok II (18 pasien) diberikan plasebo. Intervensi ini dilakukan selama 3 bulan dengan follow up skor VAS, gejala klinis yang terkait dan efek samping, dilakukan pada bulan 1 dan 3.

Dari hasil studi didapatkan bahwa pemberian sodium valproate pada 21 pasien nyeri neuropatik diabetikum dengan follow up VAS pada bulan 1 dan 3 menunjukkan penurunan skor VAS dan sensasi nyeri yang signifikan dengan nilai P <0,001; efek samping yang sering terjadi adalah mual. Sodium valproate dapat ditoleransi dan secara signifikan memberikan improvisasi terhadap pasien nyeri neuropatik diabetikum. (LWA)

Image : Ilustrasi
Referensi:
Kochar DK, Rawat N, Agrawal RP, Vyas A, Beniwal R, Kochar SK, et al. Sodium valproate for painful diabetic neuropathy: A randomized double-blind placebo-controlled study. Q J Med. 2004;97:33-8.

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## wang lili
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