Dual therapy in acanthosis nigricans: A head-to-head clinical comparison :- Medznat
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Alpha-lipoic acid + lactic acid vs. myo-inositol + lactic acid for acanthosis nigricans

Acanthosis nigricans Acanthosis nigricans
Acanthosis nigricans Acanthosis nigricans

Acanthosis nigricans (AN) is often seen in people with insulin resistance and metabolic disorders. Supplements like alpha-lipoic acid (ALA) and myo-inositol (MI) are known to enhance insulin sensitivity and metabolic balance.

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Key take away

Six-month therapy using alpha-lipoic acid + lactic acid shows slightly greater clinical improvement in acanthosis nigricans severity when compared to myo-inositol + lactic acid.

Background

Acanthosis nigricans (AN) is often seen in people with insulin resistance and metabolic disorders. Supplements like alpha-lipoic acid (ALA) and myo-inositol (MI) are known to enhance insulin sensitivity and metabolic balance. But, direct comparisons of their effectiveness in AN remain scarce. This clinical study evaluated the improvement in AN symptoms when treating patients with oral MI + topical lactic acid versus oral ALA + topical lactic acid.

The research compared the clinical effectiveness of oral myo-inositol (MI) and oral alpha-lipoic acid (ALA), each paired with topical lactic acid, in improving skin lesions in AN patients.

Method

In this hospital-based, prospective comparative trial, 72 patients suffering from AN were assigned to:

  • Group A: MI (oral) + Lactic acid (topical)
  • Group B: ALA (oral) + Lactic acid (topical)

Neck-lesion severity, measured using a standardized 0–4 grading scale, served as the primary outcome. Secondary outcomes included improvements in insulin resistance using the homeostatic model assessment of insulin resistance (HOMA-IR) index as well as treatment tolerability and safety. Appropriate statistical tests (χ² test, t-test, and one-way ANOVA, α = 0.05) were used to compare outcomes.

Result

The mean age of patients was 31.5 ± 8.2 years, and 70.8% were male. Baseline clinical characteristics and metabolic parameters, including a mean HOMA-IR of 1.68, were comparable between both groups. Following 6 months of therapy, 58.3% of all participants achieved at least one-grade improvement, while 13.9% illustrated two-grade or greater improvement in AN severity.

Mean severity reduction was notably greater in Group B (1.36 ± 0.79 grades) when compared with Group A (0.89 ± 0.71 grades), although the between-group difference of 0.47 grades did not reach statistical significance (F = 0.40, p = 0.53). Both interventions demonstrated an excellent safety profile with no severe adverse effects witnessed.

Conclusion

Both treatment strategies significantly reduced AN severity and improved metabolic indicators. ALA + lactic acid showed a greater clinical response, although the difference was not quite significant. These findings suggest either regimen can be selected based on patient needs, accessibility, and tolerability. Larger, controlled studies are needed to substantiate these outcomes.

Source:

International Journal of Pharmacy Research & Technology

Article:

A Comparative Study of Effect of Oral Myoinositol Plus Topical Lactic Acid versus Oral Alpha Lipoic Acid plus Topical Lactic Acid in Patients with Acanthosis Nigricans

Authors:

Dr. Bulbul Yadav

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