Does moxonidine reduce Achilles tendon or musculoskeletal pain in women with polycystic ovarian syndrome? A secondary analysis of a randomised controlled trial

Jacob Jewson, Elisabeth Lambert, Carolina Sari, Eveline Jona, Soulmaz Shorakae, Gavin Lambert, Jamie Gaida, Jacob Jewson, Elisabeth Lambert, Carolina Sari, Eveline Jona, Soulmaz Shorakae, Gavin Lambert, Jamie Gaida

Abstract

Background: Sympathetic activity and insulin resistance have recently been linked with chronic tendon and musculoskeletal pain. Polycystic ovarian syndrome is linked with insulin resistance and increased sympathetic drive and was therefore an appropriate condition to study the effects of modulating sympathetic activity on Achilles tendon and musculoskeletal symptoms.

Methods: A secondary analysis of a double-blinded, randomised controlled trial on women with polycystic ovarian syndrome was conducted. Participants received 12 weeks of moxonidine (n = 14) or placebo (n = 18). Musculoskeletal symptom and Victorian Institute of Sport Assessment - Achilles (VISA-A) questionnaires were distributed, and ultrasound tissue characterisation quantified tendon structure at 0 and 12 weeks. 2-way ANOVA was used for multiple comparisons.

Results: There was no difference in mean change in musculoskeletal symptoms (- 0.6 ± 1.7 vs - 0.4 ± 1.8, p = 0.69) or VISA-A (moxonidine - 0.2 ± 8.8 vs placebo + 4.2 ± 14.6, p = 0.24) attributable to the intervention. There was no difference in any measures of Achilles structure. Moxonidine did not reduce sympathetic drive when compared to placebo.

Conclusions: This was the first study to investigate the effects of blocking sympathetic drive on musculoskeletal and Achilles tendon symptoms in a metabolically diverse population. While the study was limited by small sample size and lack of sympathetic modulation, moxonidine did not change tendon pain/structure or musculoskeletal symptoms.

Trial registration: ClinicalTrials.gov, NCT01504321 . Registered 5 January 2012.

Keywords: Insulin resistance; Metabolic syndrome; Musculoskeletal pain; Polycystic ovarian syndrome; Sympathetic nervous system; Sympatholytics; Tendinopathy.

Conflict of interest statement

The laboratory of GL has recently received funding from Medtronic, Servier Australia, Abbott Pharmaceuticals, Allergan Inc. GL has acted as a consultant for Medtronic and has received honoraria from Medtronic, Pfizer and Wyeth Pharmaceuticals for presentations. These organisations played no role in the study or manuscript writing in any way.

Figures

Fig. 1
Fig. 1
Consort flow diagram of recruitment for the study

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