Volume 90, Issue 7 , Pages 1094-1101, July 2009
Periodic Salbutamol in Facioscapulohumeral Muscular Dystrophy: A Randomized Controlled Trial
Abstract
Payan CA, Hogrel JY, Hammouda EH, Lacomblez L, Ollivier G, Doppler V, Eymard B, Attarian S, Pouget J, Desnuelle C, Laforêt P. Periodic salbutamol in facioscapulohumeral muscular dystrophy: a randomized controlled trial.
Objective
To evaluate the effects on muscle strength of salbutamol administered for 6 months using a periodic regimen in patients presenting with facioscapulohumeral muscular dystrophy (FSHD).
Design
Placebo-controlled double-blind randomized study.
Setting
Three clinical centers involved in neuromuscular disorders.
Participants
Ambulatory patients (N=112), 56 per group, with genetically confirmed FSHD, age 18 to 60 years.
Interventions
Salbutamol (sustained released formulation) administered orally at a daily dose of 16mg using a periodic dosage regimen (3wks on, 1wk off).
Main Outcome Measures
Muscle strength was assessed with quantitative muscle testing (QMT), manual muscle testing (MMT), and timed motor tests. Patients were evaluated at baseline, and 3 and 6 months later. Plasma drug assays were carried out at each visit.
Results
There was no significant change with periodic use of salbutamol in the total composite QMT z-score, MMT score, or timed motor tests. Salbutamol was well tolerated. Lack of efficacy did not seem to be related to plasma concentrations, which were within the expected range.
Conclusions
Results from this study and previous controlled trials preclude at present the use of salbutamol as routine treatment for FSHD, even if we cannot exclude improvement from anabolic effects with a longer duration of treatment.
Key Words: Clinical trial, Phase III, Facioscapulohumeral muscular dystrophy, Pharmacokinetics, Rehabilitation, Salbutamol
List of Abbreviations: ECG, electrocardiogram, FSHD, facioscapulohumeral muscular dystrophy, MMT, manual muscle testing, MVIC, maximum voluntary isometric contractions, QMT, quantitative muscle testing, VAS, visual analog scale
Supported by the Association Française contre les Myopathies (AFM grant no. 6742) and sponsored by the Assistance Publique Hôpitaux de Paris (AP-HP, PHRC grant no. AOM98125).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints are not available from the author.
PII: S0003-9993(09)00208-1
doi:10.1016/j.apmr.2008.12.027
© 2009 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Volume 90, Issue 7 , Pages 1094-1101, July 2009
