Titre : | Recombinant human insulin-like growth factor I (rhIGF-I) for the treatment of amyotrophic lateral sclerosis/motor neuron disease (Review) |
Revue : | Cochrane Database of Systematic Reviews, 1, CD002064 |
Auteurs : | Mitchell JD ; Wokke JHJ ; Borasio GD |
Type de document : | Article |
Année de publication : | 14/11/2012 |
Pages : | p. 1-34 |
Langues: | Anglais |
Mots-clés : | article de type review ; critère d'inclusion ; effet indésirable ; essai clinique ; essai randomisé ; IGF1 ; qualité de vie ; revue systématique Cochrane ; sclérose latérale amyotrophique |
Résumé : |
Treatment with the growth factor, recombinant human insulin-like growth factor I, for amyotrophic lateral sclerosis (motor neuron disease)
Recombinant human insulin-like growth factor (rhIGF-I) is a genetically engineered human protein. Theoretically, it is expected to enhance the survival of motor neurons which degenerate in amyotrophic lateral sclerosis (ALS, also known as motor neuron disease (MND)). It is given by daily subcutaneous injection (injection under the skin). Three randomised controlled trials (RCTs) involving 779 participants measured disease progression on special clinical rating scales of disease severity in ALS. The review authors collected data about adverse events from the included trials. The combined results from the two included studies that used the rating scale (AALSRS) showed a small significant benefit in favour of rhIGF-I. Significant flaws in the trial designs make the statistically significant benefits in some outcomes of questionable relevance. There was an increased risk of injection site reactions with rhIGF-I. A third study using a different outcome measure showed no difference between treatment and placebo. Taken together, the available RCTs do not provide information supporting the hypothesis that rhIGF-I is an effective disease modifying treatment for ALS. All three included studies showed a high risk of bias. These issues very seriously detracted from the ability of this review to fulfil its objectives. |
Lien associé : | http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD002064/frame.html |
Pubmed / DOI : | DOI : 10.1002/14651858.CD002064.pub3 / Pubmed : 23152212 |