Recombinant human insulin-like growth factor I for amyotrophic lateral sclerosis/motor neuron disease

Recombinant human insulin-like growth factor I may slow disease progression in amyotrophic lateral sclerosis/motor neuron disease but the evidence is very limited and the clinical significance of the effect is uncertain.

A Cochrane review included 2 studies with a total of 362 subjects. The combined analysis from both randomised clinical trials showed a weighted mean difference of –4.75 (95% CI –8.41 to –1.09) favouring the treated group. The secondary outcome measures showed non-significant trends favouring recombinant human insulin-like growth factor I (rhIGF-I). Similarly the data with the 0.05 mg/kg/day dose showed trends favouring rhIGF-I at all time points but did not reach significance at the five per cent level at any point. There was an increased risk of injection site reactions with rhIGF-I (relative risk 2.53, 95% CI 1.40 to 4.59). The drug was otherwise safe and well tolerated.

Comment: The quality of evidence is downgraded by limitations in study quality and by imprecise results (few patients and wide confidence intervals).

Ədəbiyyat

1. Mitchell JD, Wokke JH, Borasio GD. Recombinant human insulin-like growth factor I (rhIGF-I) for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev 2007 Oct 17;(4):CD002064.