The effect of the aldose reductase inhibitor, ponalrestat, on the progression of diabetic retinopathy

Carlos Arauz-Pacheco, Luis C. Ramirez, Lourdes Pruneda, George E. Sanborn, Julio Rosenstock, Philip Raskin

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36 Scopus citations


The objective of this study was to evaluate the effects of ponalrestat, an aldose reductase inhibitor, on the progression of diabetic retinopathy. In this study, 62 patients with diabetes mellitus underwent a double-masked placebo-controlled clinical trial comparing the effect of ponalrestat 600 mg per day with a placebo on the progression of diabetic retinopathy. Both groups were comparable in terms of age, gender distribution, diabetes duration, metabolic control, and presence and severity of diabetic retinopathy. Seven-field stereo fundus photographs were performed at 0 (baseline), 12, and 18 months; 49 patients completed the study (26 in the ponalrestat group and 23 in the placebo group). In both treatment groups, a significant progression of diabetic retinopathy as evaluated by the Early Treatment Diabetic Retinopathy Study classification was observed (Wilcoxon Rank-Sum Test, p < 0.05). No difference was observed in the progression of retinopathy between the two treatment groups (p = 0.96). The number of microaneurysms increased in the two study groups (from 5.6 ± 1.2 to 10.5 ± 1.3 in the placebo group and from 10.3 ± 1.4 to 12.7 ± 1.4 in the ponalrestat group); however, the increase was statistically significant only in the placebo group (p < 0.05). When the increase in the number of microaneurysms was evaluated by change of category of microaneurysm count, no significant difference was observed. We conclude that ponalrestat at a dose of 600 mg per day has no clinically significant effect on the progression of diabetic retinopathy.

Original languageEnglish (US)
Pages (from-to)131-137
Number of pages7
JournalJournal of Diabetes and Its Complications
Issue number2
StatePublished - Jan 1 1992

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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