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This Article Full Text (PDF) All Versions of this Article: chest.07-2952v1 133/5/1189    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Google Scholar Articles by Lower, E. E Articles by Baughman, R. P. PubMed PubMed Citation Articles by Lower, E. E Articles by Baughman, R. P.

Double-blind, randomized trial of dexmethylphenidate hydrochloride for the treatment of Sarcoidosis Associated Fatigue

¹Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH

elower{at}ohcmail.com

Abstract

Background: Fatigue is a common complaint in sarcoidosis. We studied the effectiveness of dexmethylphenidate hydrochloride (d-MPH) in treating sarcoidosis associated fatigue.

Methods: This was a double blind, randomized placebo controlled crossover trial of d-MPH. Patients were seen weekly and completed Functional Assessment of Chronic Illness Therapy-Fatigue(FACIT-F) and Fatigue Assessment Score (FAS) instruments. After a 1 week washin, patients received either d-MPH or placebo. After 8 weeks, the medications were stopped. Following a 2 week wash-out period, patients were crossed over to 8 weeks of the other treatment. Forced vital capacity (FVC) and six minute walk distance (6MWD) were determined initially and after each treatment arm.

Results: Ten sarcoidosis patients were enrolled: 8 females and five African Americans. All were receiving systemic sarcoidosis therapy. Significant improvement in fatigue was reported by patients when receiving d-MPH (FACIT-F p<0.001, FAS p<0.02. The FVC was higher at the end of 8 weeks of d-MPH compared to the baseline values (Baseline: 2.38 l (1.17-4.53) (Median (Range)); Placebo: 2.41 l (1.50-4.65); d-MPH (2.56 l (1.50-4.96), (p<0.01)) There was no significant difference in the 6MWD (Baseline: 330 m (60-460); Placebo: 350 m (180-460); d-MPH: 390 m (200-460)). The d-MPH was well tolerated.

Conclusions: Treatment with d-MPH was associated with a significant improvement in sarcoidosis associated fatigue.

Study registered at ClinicalTrials.gov: NCT00361387