Intravenous insulin-like growth factor-I (IGF-I) in moderate-to-severe head injury: A phase II safety and efficacy trial

Jimmi Hatton, Robert P. Rapp, Kenneth A. Kudsk, Rex O. Brown, Mark S. Luer, Julie G. Bukar, Sharon A. Chen, Craig J. Mcclain, Neil Gesundheit, Robert J. Dempsey, Byron Young

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60 Scopus citations


The purpose of this study was to determine the effect of insulin-like growth factor-I (IGF-I) on the catabolic state and clinical outcome of head- injured patients. Thirty-three patients between the ages of 18 and 59 years with isolated traumatic head injury and Glasgow Coma Scale (GCS) scores of 4 to 10 were randomized to one of two groups. All patients received standard neurosurgical intensive care plus aggressive nutritional support; the patients ill the treatment group also received intravenous therapy with continuous IGF-I (0.01 mg/kg/hour). During the 14-day dosing period, the control patients lost weight, whereas treated patients gained weight despite a significantly higher measured energy expenditure and tower caloric intake (p = 0.02). Daily glucose concentrations and nitrogen outputs were greater in control patients (p = 0.03) throughout the study period. During Week l, only treated patients achieved positive nitrogen balance. Fifteen of 17 treated and 13 of 16 control patients survived the 1st week. No deaths occurred in patients whose serum IGF4 concentrations were higher than 350 ng/ml. Dichotomized Glasgow Outcome Scale scores for patients with baseline GCS scores of 5 to 7 improved from poor to good for eight of 12 treated patients but for only three of 11 control patients (p = 0.06). Eight of 11 treated patients with serum IGF-I concentrations that were at least 350 ng/ml achieved moderate-to-good outcome scores at 6 months, compared to only one of five patients with lower concentrations (p < 0.05). These findings indicate that pharmacological concentrations of IGF-1 may improve clinical outcome and nitrogen utilization in patients with moderate-to-severe head injury.

Original languageEnglish
Pages (from-to)779-786
Number of pages8
JournalJournal of Neurosurgery
Issue number5
StatePublished - May 1997


  • Glasgow Coma Scale
  • brain injury
  • insulin-like growth factor-I
  • nitrogen balance
  • nutrition
  • nutritional support
  • treatment outcome

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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