Diabetic Neuropathies Clinical Trial
Official title:
An Open-Label, Multi-Center Study to Evaluate the Safety of Long-Term Administration of TAK-128 in Subjects With Mild to Moderate Diabetic Peripheral Neuropathy
The purpose of this study is to determine the safety of TAK-128, once daily (QD), for treatment of diabetic peripheral neuropathy
Polyneuropathy is a frequent complication of diabetes; it affects most individuals after
prolonged hyperglycemia, and diabetic neuropathy is very common in the developed world.
Chronic, insidious, distal sensorimotor polyneuropathy with autonomic impairment is the most
typical form of diabetic neuropathy. Less common, but more florid presentations include
autonomic symptoms or painful neuropathy. Although many patients have no or relatively few
symptoms, the chronic polyneuropathy and autonomic dysfunction predispose to neurotrophic
foot ulceration; consequently, diabetes is the leading cause of amputation today.
Diabetic neuropathy is a dying-back polyneuropathy with distal degeneration of the longest
nerve fibers advancing in a centripetal direction. Multiple histopathological changes are
observed, but progressive fiber loss is the hallmark of diabetic polyneuropathy. Other
important features include endothelial cell basement membrane thickening, segmental
demyelination and remyelination, and axonal atrophy. Similar pathological changes are
observed in type 1 and type 2 diabetes. The severity of neuropathy as indicated by the stage
of nerve fiber loss determines the clinical, electrophysiological, and quantitative sensory
threshold features of this disorder. The functional measures of electrophysiological and
quantitative sensory thresholds reflect the morphological changes and the clinical features.
Diabetic polyneuropathy is etiologically related to prolonged hyperglycemia with multiple
consequences. Although strict glycemic control prevents neuropathy in type 1 patients if
maintained for many years, similar interventions in those with type 2 diabetes mellitus are
less successful. Type 2 patients may have neuropathy with considerable nerve fiber loss at
the time of diagnosis because of unsuspected hyperglycemia in preceding years. Reversal of
established neuropathy with strict glycemic control is not certain to occur, even if
maintained for many years. Co-morbid disease often interferes with strict management of type
2 diabetes. Even among those with type 1 diabetes, a minority of patients are successful in
maintaining prolonged euglycemia.
TAK-128 is a novel synthetic compound being developed as a treatment for diabetic
neuropathy. Subjects participating in this study successfully completed Protocol
01-04-TL-128-003, and earlier study of TAK-128.
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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