It independently prevents the head of the humerus from slipping inferiorly. The supraspinatus works in cooperation with the deltoid muscle to perform abduction, including when the arm is in an adducted position. Beyond 15 degrees the deltoid muscle becomes increasingly more effective at abducting the arm and becomes the main propagator of this action. Clinical significance
The supraspinatus forms part of the rotator cuff and is one of its most frequently damaged components, whether from acute injury or gradual degeneration. Bad posture and age are leading risk factors, with a high prevalence of unsymptomatic partial and full tears, as well as symptomatic syndromes with chronic pain. Connected pathologies include acromial impingement, frozen shoulder, and poor sleep, especially on the side. Both ultrasound and MRI are now effective methods of diagnosis. Tear
DiagnosisAntero-posterior projectional radiography of the shoulder may demonstrate a high-riding humeral head, with an acromiohumeral distance of less than 7 mm. RepairOne study has indicated that arthroscopic surgery for full-thickness supraspinatus tears is effective for improving shoulder functionality.A comparative effectiveness review  of nonoperative and operative treatments for rotator cuff tears was performed at the University of Alberta Evidence-based Practice Center in 2010. The review identified one study which reported that, "Patients receiving early surgery had superior function compared with the delayed surgical group". The review noted that the level of significance of the study was not reported, and the review chose not to include it as one of their conclusions.
This drug is most commonly dosed in a hospital setting, but can be taken at home as per specific instructions regarding preparation and storage from a doctor. The recommended dosage consists of 60 μg/kg/day. Drug interactions
Co-administration of Palifermin with Heparin should be avoided. Drug interactions with Heparin include a significantly increased systemic exposure to Palifermin. Avoid administration of Palifermin within 24 hours of myelotoxic chemotherapy, as this could result in increased oral mucositis. Pre-clinical trials
Toxicology studies
Toxicology studies were conducted by use of animal models, utilizing a variety of species, including mice, rats, and monkeys. Singles doses in rats and monkeys were given up to 30,000 and 50,000 micrograms/kg, respectively. Daily doses of 1,000 and 300 micrograms/kg, respectively, were given to rats and monkeys for 28 consecutive days. Toxic effects noted included exaggerated pharmacological effects of the drug, such as hyperkeratosis of skin and tongue and goblet cell hyperplasia in the GI tract. It was noted that the rats were more sensitive to these effects than the monkeys. Induced genetic abnormality assays including microchromosome reverse mutation and E. coli mutagenicity assays were completed using mice. There were no genotoxic effects noted from this study. Clinical trials
Phase I
Study 950170: The first in human study included administration via the subcutaneous route. This study was ended early due to the large number of adverse reactions observed around/in the injection site. Study 960136: (Dose-escalation). Intended to determine safety and tolerability, biologic activity, and pharmacokinetic profile in 61 healthy volunteers.