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Fibromyalgia


BMC Musculoskeletal Disorders 2007, 8:119doi:10.1186/1471-2474-8-119

 

Research article

 

Growth hormone as concomitant treatment in severe fibromyalgia associated with low IGF-1 serum levels. A pilot study

 

Guillem Cuatrecasas (1) , Cristina Riudavets (1) , Maria Antònia Güell (2) and Albert Nadal (3)

 

  1. Servicio de Endocrinología y Nutrición, Centro Médico Teknon, Vilana 12, E-08022 Barcelona, Spain
  2. Psicología Clínica, Centro Médico Teknon, Vilana 12, E-08022 Barcelona, Spain
  3. Servicio de Reumatología, Centro Médico Teknon, Vilana 12, E-08022 Barcelona, Spain

 

The electronic version of this article is the complete one and can be found online at:
http://www.biomedcentral.com/1471-2474/8/119

 

Published: 30 November 2007

 

© 2007 Cuatrecasas et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

 

Background

There is evidence of functional growth hormone (GH) deficiency, expressed by means of low insulin-like growth factor 1 (IGF-1) serum levels, in a subset of fibromyalgia patients. The efficacy of GH versus placebo has been previously suggested in this population. We investigated the efficacy and safety of low dose GH as an adjunct to standard therapy in the treatment of severe, prolonged and well-treated fibromyalgia patients with low IGF-1 levels.

Methods

Twenty-four patients were enrolled in a randomized, open-label, best available care-controlled study. Patients were randomly assigned to receive either 0.0125 mg/kg/d of GH subcutaneously (titrated depending on IGF-1) added to standard therapy or standard therapy alone during one year. The number of tender points, the Fibromyalgia Impact Questionnaire (FIQ) and the EuroQol 5D (EQ-5D), including a Quality of Life visual analogic scale (EQ-VAS) were assessed at different time-points.

Results

At the end of the study, the GH group showed a 60% reduction in the mean number of tender points (pairs) compared to the control group (p < 0.05; 3.25 ± 0.8 vs. 8.25 ± 0.9). Similar improvements were observed in FIQ score (p < 0.05) and EQ-VAS scale (p < 0.001). There was a prompt response to GH administration, with most patients showing improvement within the first months in most of the outcomes. The concomitant administration of GH and standard therapy was well tolerated, and no patients discontinued the study due to adverse events.

Conclusion

The present findings indicate the advantage of adding a daily GH dose to the standard therapy in a subset of severe fibromyalgia patients with low IGF-1 serum levels.

Trial Registration

NCT00497562 (ClinicalTrials.gov).

 


 

Full Text article at : http://www.biomedcentral.com/1471-2474/8/119

Also available as PDF document

 

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