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GH/IGF1 axis disturbances in the fibromyalgia syndrome: is there a rationale for GH treatment?

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Abstract

Fibromyalgia Syndrome (FMS) is a frequent idiopathic condition in which patients experience intense pain in specific tender points, profound fatigue and sleep disturbances. Although pain had not account so far in growth hormone deficiency syndrome (GHD) description, symptoms of FMS are very similar; and there is strong evidence of decreased GH secretion at least in a subset of FMS patients. Is there an overlap of the two diseases? A systematic Medline/Embase search for preliminary proof-of-concept trials, but also larger placebo-controlled studies, have shown that GH replacement in low-IGF1 patients can significantly improve some symptoms of FMS and quality of life, suggesting a direct causal effect of GH deficiency. Despite the use of relatively high doses of GH in these patients, treatment seems to be well tolerated. Several mechanisms of action for GH in FMS relief have been suggested, including both central modulation of pain and peripheral musculo-tendinous effects, as already described in classic GHD.

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Conflict of interest

Receiving fees for lecturing and advisory boards from Ipsen and Merck (GC), and Novartis and Pfizer (FFC).

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Authors and Affiliations

  1. Endocrinology Department, CPEN S.L, CM Teknon and Clinica Sagrada Familia, Barcelona, Spain

    G. Cuatrecasas

  2. Rheumatology Department, Institut Universitari Dexeus, Barcelona, Spain

    C. Alegre

  3. Department of Medicine, Complejo Hospitalario Universitario de Santiago (CHUS), CIBER de Fisiopatologia Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain

    F. F. Casanueva

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  1. G. Cuatrecasas
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  2. C. Alegre
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  3. F. F. Casanueva
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Correspondence to G. Cuatrecasas.

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Cuatrecasas, G., Alegre, C. & Casanueva, F.F. GH/IGF1 axis disturbances in the fibromyalgia syndrome: is there a rationale for GH treatment?. Pituitary 17, 277–283 (2014). https://doi.org/10.1007/s11102-013-0486-0

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