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Minerva Orthopedics 2021 June;72(3):336-40

DOI: 10.23736/S2784-8469.21.04161-4


language: English

The synergistic effect of palmitoylethanolamide and acetyl-L-carnitine in the treatment of peripheral neuropathies secondary to rheumatic diseases

Simone PARISI , Maria Chiara DITTO, Richard BORRELLI, Enrico FUSARO

Rheumatology Unit, Department of General and Specialist Medicine, Città della Salute e della Scienza, Turin, Italy

BACKGROUND: The neurologic complications of rheumatic diseases (RDs), including mononeuritis multiplex, nerve entrapment and vasculitic sensorimotor neuropathies, are highly variable. The therapy for these disorders is not simple and often requires a multiple approach. palmitoylethanolamide (PEA) and acetyl-L-carnitine (ALC) have been found safe and effective for nerve compression syndromes and painful peripheral neuropathy respectively, demonstrating a synergistic effect when associated. The aim of our study was to evaluate the efficacy of supplementation of standard therapy (STh) with a fixed combination of PEA+ALC (PEA+ALC FC) in patients with peripheral neuropathy secondary to RDs.
METHODS: Patients at the time of enrolment had been affected by RDs (RA or SpA) with neuropathy for <12 months, documented by electromyography. Patients were treated with the STh according to their rheumatic disease and for their neuropathy (e.g., analgesics, NSAIDs, pregabalin or gabapentin) as per clinical practice. The sample was divided into two groups: group 1, consisting of 42 patients treated with STh plus PEA+ALC FC twice a day for 2 weeks, and then once a day for 6 months; group 2, consisting of 40 patients treated with STh only. Each patient underwent clinical evaluations and questionnaires were administered in order to evaluate their neuropathy and the efficacy of the therapy.
RESULTS: Patients treated with STh plus PEA+ALC FC had a significant improvement in pain VAS compared to patients treated with group 2 in all the diseases analyzed (sciatic pain: P=0.032, carpal tunnel syndrome: P=0.025, lower limbs neuropathy: P=0.041). Patients from group 1 showed a significant improvement compared to patients treated in group 2 also from a specific score. Specifically, LBP-IQ showed significant improvement in group 1 (P=0.031), as did CHFD (P=0.011) and NPQ (P=0.025).
CONCLUSIONS: The synergistic effect of PEA and ALC seems to have a further advantage in the treatment of neurologic involvements of RDs.

KEY WORDS: Rheumatic diseases; Palmidrol; Acetylcarnitine

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