A six-month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia

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Article Source: Arthritis Rheum. 2008 Jan 31;58(2):612-622 [Epub ahead of

print]

The subject article talks about a medication called Pyridostigmine in

combination with exercise in fibromyalgia patients.

I have included more information about the medication, which you may be more

familiar with of under name of " Reginol " .

FYI:

http://www.medicinenet.com/pyridostigmine-oral/article.htm

GENERIC NAME: PYRIDOSTIGMINE - ORAL (pir-id-oh-STIG-meen)

BRAND NAME(S): Mestinon

USES: Pyridostigmine is used to treat a muscle disease (myasthenia gravis)

or to counteract the effects of certain muscle relaxant medication.

http://en.wikipedia.org/wiki/Pyridostigmine

Pyridostigmine

From Wikipedia, the free encyclopedia

Pyridostigmine is a parasympathomimetic and a reversible cholinesterase

inhibitor. Since it is a quaternary amine, it is poorly absorbed in the gut

and doesn't cross the blood-brain barrier, except possibly in stressful

conditions.[1]

Pyridostigmine bromide is available under the trade names MestinonR (Valeant

Pharmaceuticals) and RegonolR.

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682229.html

Pyridostigmine is used to decrease muscle weakness resulting from myasthenia

gravis.

Following is the abstract from journal, Arthritis and Rheumatism, published

here ahead of print.

Shari Ferbert

www.AFFTER.org

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Arthritis Rheum. 2008 Jan 31;58(2):612-622 [Epub ahead of print]

KD, Burckhardt CS, Deodhar AA, Perrin NA, Hanson GC, RM.

Oregon Health & Science University, Portland.

PMID: 18240245

A six-month randomized controlled trial of exercise and

pyridostigmine in the treatment of fibromyalgia.

OBJECTIVE: A subset of fibromyalgia (FM) patients have a

dysfunctional hypothalamic-pituitary-insulin-like growth factor 1

(IGF-1) axis, as evidenced by low serum levels of IGF-1 and a reduced

growth hormone (GH) response to physiologic stimuli. There is

evidence that pyridostigmine (PYD) improves the acute response of GH

to exercise in FM patients. The purpose of this study was to evaluate

the clinical effectiveness of 6 months of PYD and group exercise on

FM symptoms.

METHODS: FM patients were randomized to 1 of the following 4 groups:

PYD plus exercise, PYD plus diet recall but no exercise, placebo plus

exercise, and placebo plus diet recall but no exercise. The primary

outcome measures were the visual analog scale (VAS) score for pain,

tender point count, and total myalgic score. Secondary outcome

measures were the total score on the Fibromyalgia Impact

Questionnaire (FIQ) and FIQ VAS scores for individual symptoms

(fatigue, poor sleep, stiffness, and anxiety), as well as quality of

life (QOL) and physical fitness (lower body strength/endurance, upper

and lower body flexibility, balance, and time on the treadmill).

RESULTS: A total of 165 FM patients completed baseline measurements;

154 (93.3%) completed the study. The combination of PYD and exercise

did not improve pain scores. PYD groups showed a significant

improvement in sleep and anxiety in those who completed the study and

in QOL in those who complied with the therapeutic regimen as compared

with the placebo groups. Compared with the nonexercise groups, the 2

exercise groups demonstrated improvement in fatigue and fitness. PYD

was generally well tolerated.

CONCLUSION: Neither the combination of PYD plus supervised exercise

nor either treatment alone yielded improvement in most FM symptoms.

However, PYD did improve anxiety and sleep, and exercise improved

fatigue and fitness. We speculate that PYD may have improved vagal

tone, thus benefiting sleep and anxiety; this notion warrants further study.

Shari

Shari Ferbert

President, AFFTER

Advocates for Fibromyalgia Funding,

Treatment, Education and Research

www.affter.org