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Efficacy and Safety of an Oral Growth Hormone Drug in the Treatment of Fibromyalgia

Primary Purpose

Fibromyalgia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ibutamoren Mesylate (MK-0677)
Sponsored by
Bennett, Robert, M.D.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Fibromyalgia focused on measuring Fibromyalgia, Treatment, Growth hormone, IGF-1, MK-0677, Oral growth hormone secretagogue

Eligibility Criteria

30 Years - 65 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Subjects will all be female primary fibromyalgia subjects who are 30 to 65 years of age, inclusive, and have a low age adjusted serum IGF-1 level. All subjects will fulfill a diagnosis of fibromyalgia according to the classification criteria of the American College of Rheumatology (ACR). All subjects will have an initial Fibromyalgia Impact Questionnaire (FIQ) score ≥ 40. If subject is of childbearing potential and sexually active, she agrees to use effective barrier or appropriate oral contraception during the study. Subjects who are taking oral contraceptives must have done so for at least 2 months prior to entering the study. Subject is not pregnant and is not nursing. Patient has a normal screening breast exam. If screening breast exam is abnormal, but not suggestive of breast cancer, the patient must have had a normal mammogram within the last 6 months. Subject has a normal screening stool hemoccult. If the screening stool hemoccult is abnormal, but likely due to hemorrhoids, the subject must have had a normal sigmoidoscopy within the last 2 years. Subject is willing to discontinue using grapefruit juice for duration of study. Subject is willing to be followed by telephone contact for 3 months after she has discontinued study and completed and returned the Fibromyalgia Impact Questionnaire, Patient Global Change score, Quality of Life score, Brief Pain Inventory and Beck Depression Questionnaire. Exclusion Criteria: Subject has an-ongoing, unresolved disability litigation. Subject has diabetes or a significantly elevated random glucose at the Screening visit. Subject has a current or past history of cardiovascular, pulmonary, neurological, endocrine or renal disease that would preclude involvement in an exercise program (specifically hypertension, a myocardial infarction within the last 6 months, chronic obstructive pulmonary disease [COPD], asthma, untreated hypothyroidism, severe depression with suicide risk, previous pituitary disease or surgery). Subject has a history of angina or congestive heart failure with symptoms that occur at rest. Subject has a history or current evidence of a psychotic disorder (e.g. schizophrenia), bipolar disorder or major depression, or substance abuse by DSM-IV criteria; severe depression, as evidenced by a Beck Depression score of ≥ 30. Subject has history of neurological disorder other than fibromyalgia (e.g. epilepsy, stroke, neuropathy, neuropathic pain). Subject has ongoing symptoms of carpal tunnel syndrome. Subject has any other significant pain state, i.e. subject must have primary fibromyalgia. Subject has a history of hepatitis or liver disease that has been active within the past 12 weeks. Subject has cancer or a history of cancer within the past 2 years, or a history of cancer of more than 2 years ago and deemed to not be cured, or subject has ANY history of breast cancer. (NOTE: Subjects with a history of basal cell or squamous cell carcinoma of the skin treated more than 1 year ago and with no evidence of recurrence may participate.) Subject has abnormal thyroid stimulating-hormone, or T4 concentrations. Subject has a planned elective surgery during the study period. Subject has a history of hypersensitivity or idiosyncratic reaction to more than 2 drug classes (by chemical classification). Subject has abnormal Screening visit laboratory values. Subject is using any of the following medications : heparin, ticlopidine, ginko (in subjects taking warfarin), oral steroids (>/= 7 days per month), chronic use of strong CYP3A4 inhibitors (HIV protease inhibitors, macrolide antibiotics and nefazodone), chronic use of CYP3A4 inducers (carbamazepine, phenytoin, rifampin, and St. John's Wort). p. Subject has received an investigational drug or device within 30 days of study entry.

Sites / Locations

  • Oregon Health & Science University

Arms of the Study

Arm 1

Arm Type

Placebo Comparator

Arm Label

Placebo

Arm Description

Placebo

Outcomes

Primary Outcome Measures

MK-0677 25 mg is superior to placebo in reducing symptoms of fibromyalgia, as assessed by the Fibromyalgia Impact Questionnaire (FIQ) over a 24-week treatment period
MK-0677 25 mg is generally safe and well tolerated in subjects with fibromyalgia

Secondary Outcome Measures

MK-0677 25 mg is superior to placebo in improving the subjects' global perception of change in fibromyalgia symptoms, as assessed by the Subjects' Global Impression of Change Questionnaire (PGIC)
MK-0677 25 mg is superior to placebo in improving the subjects' quality of life, as assessed by the Quality of Life Questionnaire (QOL)

Full Information

First Posted
June 27, 2005
Last Updated
August 2, 2012
Sponsor
Bennett, Robert, M.D.
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT00116129
Brief Title
Efficacy and Safety of an Oral Growth Hormone Drug in the Treatment of Fibromyalgia
Official Title
A Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety and Efficacy of MK-0677 25 mg in the Treatment of Primary Fibromyalgia
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Completed
Study Start Date
July 2005 (undefined)
Primary Completion Date
January 2008 (Actual)
Study Completion Date
April 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Bennett, Robert, M.D.
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a 24-week, randomized, double-blind, placebo-controlled, trial to evaluate the safety, tolerability and efficacy of an orally administered growth hormone stimulating drug, (code named MK-0677) in the treatment of female subjects with primary fibromyalgia. The basis for this study is the observation that many fibromyalgia patients are growth hormone deficient; an earlier study of injectable growth hormone had shown benefit in this population of fibromyalgia patients.
Detailed Description
This study examines whether MK-0677 treatment will improve symptoms of fibromyalgia (FM). The rationale for this study is the observation that many fibromyalgia patients are growth hormone deficient in terms of low levels of IGF-1, and that improving IGF-1 levels with growth hormone injections has been shown to improve fibromyalgia symptoms. MK-0677 is an orally administered growth hormone secretagogue manufactured by Merck & Co., Inc. that acts on the growth hormone secretagogue receptor in the anterior pituitary to stimulate the release of growth hormone. This pathway represents an additional regulation of growth hormone release from pituitary somatotrophs to that mediated by growth hormone releasing hormone (stimulating) and somatostatin (inhibitory). Both stimulatory pathways lead to a pulsatile release of growth hormone, with approximately 4 hour intervals between peak levels. This growth hormone secretion leads to a rapid and robust up regulation of IGF-1 levels by about 50 to 100% that can be maintained with chronic therapy at a dose of 25 mg/day. The primary aims of this study are: To evaluate the efficacy of MK-0677 25 mg in primary fibromyalgia subjects over a 24-week treatment period, as assessed by the FIQ. To evaluate the safety and tolerability of MK-0677 25 mg in subjects with fibromyalgia. The secondary aims of this study are to determine whether: MK-0677 25 mg is superior to placebo in reducing muscle tenderness, as assessed by the Fibromyalgia Myalgic Score (FMyS). MK-0677 25 mg is superior to placebo in improving the subjects' global perception of change in fibromyalgia symptoms, as assessed by the Subjects' Global Impression of Change Questionnaire (PGIC). MK-0677 25 mg is superior to placebo in improving the subjects' quality of life, as assessed by the Quality of Life Questionnaire (QOL).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fibromyalgia
Keywords
Fibromyalgia, Treatment, Growth hormone, IGF-1, MK-0677, Oral growth hormone secretagogue

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
64 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Ibutamoren Mesylate (MK-0677)
Intervention Description
Ibutamoren Mesylate 25 mg/day
Primary Outcome Measure Information:
Title
MK-0677 25 mg is superior to placebo in reducing symptoms of fibromyalgia, as assessed by the Fibromyalgia Impact Questionnaire (FIQ) over a 24-week treatment period
Time Frame
Six months
Title
MK-0677 25 mg is generally safe and well tolerated in subjects with fibromyalgia
Time Frame
Six months
Secondary Outcome Measure Information:
Title
MK-0677 25 mg is superior to placebo in improving the subjects' global perception of change in fibromyalgia symptoms, as assessed by the Subjects' Global Impression of Change Questionnaire (PGIC)
Time Frame
Six months
Title
MK-0677 25 mg is superior to placebo in improving the subjects' quality of life, as assessed by the Quality of Life Questionnaire (QOL)
Time Frame
Six months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects will all be female primary fibromyalgia subjects who are 30 to 65 years of age, inclusive, and have a low age adjusted serum IGF-1 level. All subjects will fulfill a diagnosis of fibromyalgia according to the classification criteria of the American College of Rheumatology (ACR). All subjects will have an initial Fibromyalgia Impact Questionnaire (FIQ) score ≥ 40. If subject is of childbearing potential and sexually active, she agrees to use effective barrier or appropriate oral contraception during the study. Subjects who are taking oral contraceptives must have done so for at least 2 months prior to entering the study. Subject is not pregnant and is not nursing. Patient has a normal screening breast exam. If screening breast exam is abnormal, but not suggestive of breast cancer, the patient must have had a normal mammogram within the last 6 months. Subject has a normal screening stool hemoccult. If the screening stool hemoccult is abnormal, but likely due to hemorrhoids, the subject must have had a normal sigmoidoscopy within the last 2 years. Subject is willing to discontinue using grapefruit juice for duration of study. Subject is willing to be followed by telephone contact for 3 months after she has discontinued study and completed and returned the Fibromyalgia Impact Questionnaire, Patient Global Change score, Quality of Life score, Brief Pain Inventory and Beck Depression Questionnaire. Exclusion Criteria: Subject has an-ongoing, unresolved disability litigation. Subject has diabetes or a significantly elevated random glucose at the Screening visit. Subject has a current or past history of cardiovascular, pulmonary, neurological, endocrine or renal disease that would preclude involvement in an exercise program (specifically hypertension, a myocardial infarction within the last 6 months, chronic obstructive pulmonary disease [COPD], asthma, untreated hypothyroidism, severe depression with suicide risk, previous pituitary disease or surgery). Subject has a history of angina or congestive heart failure with symptoms that occur at rest. Subject has a history or current evidence of a psychotic disorder (e.g. schizophrenia), bipolar disorder or major depression, or substance abuse by DSM-IV criteria; severe depression, as evidenced by a Beck Depression score of ≥ 30. Subject has history of neurological disorder other than fibromyalgia (e.g. epilepsy, stroke, neuropathy, neuropathic pain). Subject has ongoing symptoms of carpal tunnel syndrome. Subject has any other significant pain state, i.e. subject must have primary fibromyalgia. Subject has a history of hepatitis or liver disease that has been active within the past 12 weeks. Subject has cancer or a history of cancer within the past 2 years, or a history of cancer of more than 2 years ago and deemed to not be cured, or subject has ANY history of breast cancer. (NOTE: Subjects with a history of basal cell or squamous cell carcinoma of the skin treated more than 1 year ago and with no evidence of recurrence may participate.) Subject has abnormal thyroid stimulating-hormone, or T4 concentrations. Subject has a planned elective surgery during the study period. Subject has a history of hypersensitivity or idiosyncratic reaction to more than 2 drug classes (by chemical classification). Subject has abnormal Screening visit laboratory values. Subject is using any of the following medications : heparin, ticlopidine, ginko (in subjects taking warfarin), oral steroids (>/= 7 days per month), chronic use of strong CYP3A4 inhibitors (HIV protease inhibitors, macrolide antibiotics and nefazodone), chronic use of CYP3A4 inducers (carbamazepine, phenytoin, rifampin, and St. John's Wort). p. Subject has received an investigational drug or device within 30 days of study entry.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Bennett, MD
Organizational Affiliation
Oregon Health and Science University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
9228141
Citation
Bennett RM, Cook DM, Clark SR, Burckhardt CS, Campbell SM. Hypothalamic-pituitary-insulin-like growth factor-I axis dysfunction in patients with fibromyalgia. J Rheumatol. 1997 Jul;24(7):1384-9.
Results Reference
background
PubMed Identifier
9552084
Citation
Bennett RM, Clark SC, Walczyk J. A randomized, double-blind, placebo-controlled study of growth hormone in the treatment of fibromyalgia. Am J Med. 1998 Mar;104(3):227-31. doi: 10.1016/s0002-9343(97)00351-3.
Results Reference
background

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Efficacy and Safety of an Oral Growth Hormone Drug in the Treatment of Fibromyalgia

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