Finckh Axel, Berner Isabelle Carey, Aubry-Rozier Bérengère, So Alexander Kai-Lik
Rheumatology Department, University Hospital of Vaud (CHUV), Lausanne, Switzerland.
J Rheumatol. 2005 Jul;32(7):1336-40.
Patients with fibromyalgia (FM) consistently have adrenal hyporesponsiveness and low dehydroepiandrosterone (DHEA) levels. DHEA is promoted for and used by patients with FM. We tested the efficacy and safety of DHEA supplementation in ameliorating the symptoms of FM.
In a double-blind crossover study, postmenopausal women with FM were randomized to DHEA supplementation (50 mg/day) or placebo for 3 months, with a one-month washout period in between. Patients were assessed monthly for well-being and pain and by medical evaluations at the beginning and the end of each treatment period. The primary outcome was well being; secondary outcomes were pain, fatigue, cognition, sexuality, functional impairment, depression, and anxiety.
A total of 52 patients were randomized, 47 patients completed the DHEA treatment period, and 45 the placebo treatment period. After 3 months of treatment with 50 mg of DHEA, median DHEA sulfate blood levels had tripled, but there was no improvement in well-being, pain, fatigue, cognitive dysfunction, functional impairment, depression, or anxiety, nor in objective measurements made by physicians. Androgenic side effects (greasy skin, acne, and increased growth of body hair) were more common during the DHEA treatment period (p = 0.02).
DHEA does not improve quality of life, pain, fatigue, cognitive function, mood, or functional impairment in FM.
纤维肌痛(FM)患者一直存在肾上腺反应性低下和脱氢表雄酮(DHEA)水平降低的情况。FM患者会使用并推崇DHEA。我们测试了补充DHEA改善FM症状的疗效和安全性。
在一项双盲交叉研究中,绝经后FM女性被随机分为补充DHEA组(50毫克/天)或安慰剂组,为期3个月,中间有1个月的洗脱期。在每个治疗期开始和结束时,每月对患者的幸福感和疼痛进行评估,并进行医学评估。主要结局是幸福感;次要结局是疼痛、疲劳、认知、性功能、功能障碍、抑郁和焦虑。
共有52名患者被随机分组,47名患者完成了DHEA治疗期,45名患者完成了安慰剂治疗期。用50毫克DHEA治疗3个月后,硫酸脱氢表雄酮血液水平中位数增加了两倍,但幸福感、疼痛、疲劳、认知功能障碍、功能障碍、抑郁或焦虑均未改善,医生的客观测量结果也未改善。在DHEA治疗期间,雄激素副作用(皮肤油腻、痤疮和体毛增多)更为常见(p = 0.02)。
DHEA不能改善FM患者的生活质量、疼痛、疲劳、认知功能、情绪或功能障碍。