Pilot clinical trial of dehydroepiandrosterone (DHEA) versus placebo for Sjögren's syndrome

Stanley R. Pillemer, Michael T. Brennan, Vidya Sankar, Rose Anne Leakan, Janine A. Smith, Margaret Grisius, Sophie Ligier, Lida Radfar, Marc R. Kok, Albert Kingman, Philip C. Fox

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Objective. To screen for potential efficacy and assess feasibility and safety of dehydroepiandrosterone (DHEA) as a treatment for Sjögren's syndrome (SS). Methods. A 24-week randomized, double-blinded, pilot trial of oral DHEA (200 mg/day) versus placebo was conducted. The primary comparison was to a hypothesized 20% placebo response rate. If 14 consecutive subjects on DHEA did not respond, a Phase III trial would be considered futile. A placebo group of 14 subjects was planned to verify placebo response rate and estimate sample size required for a definitive trial. Response criteria required 20% improvement in at least 2 of 3 domains. Analysis of covariance was used to adjust for baseline differences and for stratified randomization. Outcome measures included visual analog scale questionnaires for dry eye and dry mouth symptoms, lissamine green ocular dye staining and Schirmer I tests, stimulated salivary flow, IgG, and erythrocyte sedimentation rate (ESR). Results. Randomization resulted in 14 DHEA and 14 placebo group subjects. At baseline, mean ± SD for DHEA versus placebo groups were Schirmer I tests 4.5 ± 4.5 versus 5.4 ± 6.1 mm/5 minutes; Van Bijsterveld score 5.3 ± 2.1 versus 5.5 ± 2.2; unstimulated saliva 0.03 ± 0.05 versus 0.04 ± 0.10 ml/minute; IgG 1,699 ± 749 versus 1,712 ± 621 g/dl; and ESR 40 ± 31 versus 44 ± 28 mm/hour. Apart from changes over the trial in dry mouth symptoms, no significant differences were noted between the DHEA and placebo groups for dry eye symptoms, objective measures of ocular dryness, stimulated salivary flow; IgG, or ESR. Four DHEA and one placebo group patient dropped out because of adverse effects. Although 7 subjects met response criteria in the DHEA group, 5 met the criteria in the placebo group, and there was no significant difference between groups. Conclusion. DHEA showed no evidence of efficacy in SS. Without evidence for efficacy, patients with SS should avoid using unregulated DHEA supplements, since long-term adverse consequences of exposure to this hormone are unknown.

Original languageEnglish (US)
Pages (from-to)601-604
Number of pages4
JournalArthritis Care and Research
Volume51
Issue number4
StatePublished - Aug 15 2004

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Keywords

  • Clinical trial
  • Dehydroepiandrosterone
  • Sjögren's Syndrome

ASJC Scopus subject areas

  • Rheumatology

Cite this

Pillemer, S. R., Brennan, M. T., Sankar, V., Leakan, R. A., Smith, J. A., Grisius, M., Ligier, S., Radfar, L., Kok, M. R., Kingman, A., & Fox, P. C. (2004). Pilot clinical trial of dehydroepiandrosterone (DHEA) versus placebo for Sjögren's syndrome. Arthritis Care and Research, 51(4), 601-604.