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Evidence summaries

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. Level of evidence: "C"

A Cochrane review [Abstract] 1 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).

References

  • 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. [PubMed]

Primary/Secondary Keywords