Growth Hormone in Neuroendocrine Dysfunction With Severe Fibromyalgia Syndrome
Growth Hormone Treatment of Severe Fibromyalgia Syndrome Associated With Functional Failure of Somatotropic Axis. A Multicentre, Randomized, Double-blind, Placebo-controlled Study.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Barcelona, Spain
- Centro Medico Teknon, Endocrinology Department
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Women aged greater than or equal (>=) 18 years
- Fibromyalgia diagnosed at least one year before
- History of generalized pain and at least 16 positive tender points (1990 American College of Rheumatology [ACR] criteria)
- Body Mass Index (BMI) less than or equal to(=<) 32
- Normal GH stimulation test (insulin)
- Stable (>= 3 months unchanged) standard treatment with amitriptyline (10-50 milligram per day [mg/day]) plus selective serotonin reuptake inhibitor (10-40 mg/day) plus tramadol (25-400 mg/day)
- Active rehabilitation program during the previous year (at least 30 minutes/day)
- Fibromyalgia Impact Questionnaire (FIQ) score >=75
- IGF-1 serum level =< 150 nanogram/milliliter (ng/mL) otherwise =< 2 SD of the local lab normality)
- Normal response to IGF-1 generation test
- Chronic Fatigue Symptoms (Multidimensional Assessment of Fatigue [MAF])
- Effective anti-conception
- Willingness to comply with the protocol
- Written Informed consent
Exclusion Criteria:
- Major psychiatric condition
- Rheumatic disease, including systemic lupus erythematosus (SLE)
- Previous or current malignancies, active or inactive
- Clinical history intracranial space occupying lesion
- Reactive or secondary (rheumatoid arthritis [RA], osteoarthritis) fibromyalgia syndrome (FMS)
- Antinuclear antibody (ANA) greater than or equal 1:80
- Abnormal Creatine phosphokinase (CPK) or aldolase serum levels
- Not controlled thyroid disease in the last 3 months (free Thyroxine [T4] and Thyrotrophin-stimulating hormone [TSH] serum levels)
- Diabetes mellitus
- Adrenal gland disease (any abnormal cortisolemia, will be confirmed by 24-hour cortisoluria)
- Pregnancy or breast feeding
- Known to be hypersensitive to somatotropin or any of the excipients
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Saizen®
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Saizen® (Somatropin) 0.006 milligram per kilogram (mg/kg) will be administered subcutaneously daily for 12 months.
Dose will be titrated (an increase of 0.2 milligram per day) if the increase in insulin-like growth factor 1 (IGF-1) is less than 50 percent of the baseline value.
Dose titrations will be made at Month 1, 3, 7 and 9.
Other Names:
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Active Comparator: Placebo + Saizen®
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Placebo matched to Saizen® will be administered for the first 6 months followed by treatment with Saizen® (Somatropin) 0.006 mg/kg subcutaneously daily for next 6 months.
Saizen® dose will be titrated (an increase of 0.2 milligram per day) if the increase in insulin-like growth factor 1 (IGF-1) is less than 50 percent of the baseline value.
Dose titrations will be made at Month 7 and 9.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percentage of Participants With Less Than 11 Tender Points at Month 6
Time Frame: Month 6
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The musculoskeletal component in form of pain on palpation in at least 11 of 18 tender point sites is required to fulfill the American College of Rheumatology (ACR) criteria for fibromyalgia syndrome, An important response is considered when the number of tender points falls below 11 since it is the threshold for fibromyalgia diagnosis.
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Month 6
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Percentage of Participants With Less Than 11 Tender Points at Month 12
Time Frame: Month 12
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The musculoskeletal component in form of pain on palpation in at least 11 of 18 tender point sites is required to fulfill the ACR criteria for fibromyalgia syndrome, An important response is considered when the number of tender points falls below 11 since it is the threshold for fibromyalgia diagnosis.
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Month 12
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Fibromyalgia Impact Questionnaire (FIQ) Total Score
Time Frame: Baseline, Month 1, 3, 6, 7, 9 and 12
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Fibromyalgia Impact Questionnaire (FIQ) is a 10-item questionnaire that measures physical impairment, well-being, missed work, pain, fatigue, rest, stiffness, anxiety, and depression.
Score ranges from 0 (best result - very well) to 100 (worst result - awful).
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Baseline, Month 1, 3, 6, 7, 9 and 12
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Visual Analog Scale (VAS) Total Score
Time Frame: Baseline, Month 1, 3, 6, 7, 9 and 12
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Visual Analog Scale (VAS) is a 100 millimeter (mm) scale.
Intensity of pain range: 0 mm=no pain to 100 mm=worst possible pain.
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Baseline, Month 1, 3, 6, 7, 9 and 12
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EuroQol 5-Dimensions (EQ-5D) Total Score
Time Frame: Baseline, Month 1, 3, 6, 7, 9 and 12
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EuroQol 5-Dimensions (EQ-5D) questionnaire is a measure of health status and quality of life (QoL).
The EQ-5D defines health in terms of mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
Score range for each item is 0 to 3, with 3 being the most severe.
Total score range is 0 to 15. Lower scores represent a better QoL.
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Baseline, Month 1, 3, 6, 7, 9 and 12
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Multidimensional Assessment of Fatigue (MAF) Total Score
Time Frame: Baseline, Month 6 and 12
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Multidimensional Assessment of Fatigue (MAF) consists of 16 questions.
The score range for first 14 questions is between 0 and 10 for each question while for the last two questions it is 0 and 4 for each question.
Total score range for first 14 questions is 0 to 100 and for last two questions is 0 to 8. Lower scores on the each represent the better participant's condition, whereas, higher scores indicate worsening condition.
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Baseline, Month 6 and 12
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Percentage of Participants With Positive Response on Quality of Life Assessment of Growth Hormone [GH] Deficiency in Adults (QoL AGHDA) Scale
Time Frame: Baseline, Month 6 and 12
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Quality of Life Assessment of GH Deficiency in Adults (QoL AGHDA) questionnaire consists of 25 items that evoke yes or no answers.
A score of 1 is given to each item affirmed and these are summed to give the total score.
The maximum score is 25, which represents a poor quality of life.
The minimum score is 0, which represents a good quality of life.
Each question has to be answered with a NO/YES and for each YES, one point is added.
The more YES, the higher the score and the worse.
Decrease in the positive responses is an index of improvement.
So, when the percentage of positive responses on the scale decreases, it is considered a response rate.
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Baseline, Month 6 and 12
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Guillem Cuatrecasas, MD, Centro Médico Teknon
Publications and helpful links
General Publications
- Cuatrecasas G, Alegre C, Fernandez-Sola J, Gonzalez MJ, Garcia-Fructuoso F, Poca-Dias V, Nadal A, Cuatrecasas G, Navarro F, Mera A, Lage M, Peino R, Casanueva F, Linan C, Sesmilo G, Coves MJ, Izquierdo JP, Alvarez I, Granados E, Puig-Domingo M. Growth hormone treatment for sustained pain reduction and improvement in quality of life in severe fibromyalgia. Pain. 2012 Jul;153(7):1382-1389. doi: 10.1016/j.pain.2012.02.012. Epub 2012 Mar 31.
- Cuatrecasas G, Gonzalez MJ, Alegre C, Sesmilo G, Fernandez-Sola J, Casanueva FF, Garcia-Fructuoso F, Poca-Dias V, Izquierdo JP, Puig-Domingo M. High prevalence of growth hormone deficiency in severe fibromyalgia syndromes. J Clin Endocrinol Metab. 2010 Sep;95(9):4331-7. doi: 10.1210/jc.2010-0061. Epub 2010 Jul 14.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 27560
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