Lipoic acid

7709 studies identified, 62 included after deduplication and assessment. Most studies were blinded with sample sizes ranging from 15 to 270 patients. 70 different plants from 44 families were identified. Risk of bias assessment showed 27 studies with concerns, 22 with low risk, and 13 with high risk. 62 papers identified 17 orofacial pain conditions categorized into six groups. Meta-analyses found herbal extracts more effective in reducing periodontal, oral surgery, oral neuropathic, endodontic, oral mucosal, and TMD pain compared to standard therapies.

A network meta-analysis by Omid Kohandel Gargari, MD, found that pregabalin and topiramate, with or without vitamin D3, reduced migraine frequency in children and adolescents. Other treatments like flunarizine, levetiracetam, riboflavin, amitriptyline, and cinnarizine also showed potential but required more studies. Combination therapies, especially with vitamin D3, showed significant benefits, though no treatments significantly improved quality of life or reduced attack duration. Adverse events were highest with amitriptyline, topiramate, and valproate.

The OCTOPUS trial, assessing R/S alpha-lipoic acid and metformin in progressive MS, updated at ECTRIMS 2024, reports 189 of 375 participants randomized by March 2024. The study aims to address the unmet need for treatments in progressive MS, with ocrelizumab being the only FDA-approved therapy. Lipoic acid and metformin are hypothesized to impact immune response and promote myelin repair, respectively.