Double-blind, randomized, placebo-controlled crossover trial of alpha-lipoic acid for the treatment of fibromyalgia pain: the IMPALA trial

纤维肌痛 安慰剂 医学 随机对照试验 不利影响 物理疗法 交叉研究 临床试验 析因分析 内科学 慢性疼痛 替代医学 病理
作者
Ian Gilron,Sylvia Robb,Dongsheng Tu,Ronald R. Holden,Tanveer Towheed,Dan Ziegler,Louie Wang,Roumen Milev,Christopher Gray
出处
期刊:Pain [Ovid Technologies (Wolters Kluwer)]
卷期号:162 (2): 561-568 被引量:16
标识
DOI:10.1097/j.pain.0000000000002028
摘要

Abstract Fibromyalgia is a common and challenging chronic pain disorder with few, if any, highly effective and well-tolerated treatments. Alpha-lipoic acid (ALA) is a nonsedating antioxidant with evidence of efficacy in the treatment of symptomatic diabetic neuropathy that has not been evaluated in the setting of fibromyalgia treatment. Thus, we conducted a single-centre, proof-of-concept, randomized, placebo-controlled, crossover trial of ALA for the treatment of fibromyalgia. Twenty-seven participants were recruited, and 24 participants completed both treatment periods of the trial. The median maximal tolerated dose of ALA in this trial was 1663 mg/day. Treatment-emergent adverse events with ALA were infrequent and not statistically different from placebo. For the primary outcome of pain intensity, and for several other validated secondary outcomes, there were no statistically significant differences between placebo and ALA. A post hoc exploratory subgroup analysis showed a significant interaction between gender and treatment with a significant favourable placebo–ALA difference in pain for men, but not for women. Overall, the results of this trial do not provide any evidence to suggest promise for ALA as an effective treatment for fibromyalgia, which is predominantly prevalent in women. This negative clinical trial represents an important step in a collective strategy to identify new, better tolerated and more effective treatments for fibromyalgia.
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