[URL="http://www.ctvnews.ca/health/ms-treatme ... z20upUkXQL"][U]MS treatment[/U][/URL] reduces relapses, but can’t slow progression: study
[QUOTE]Many multiple sclerosis patients have complained for years that commonly used MS drugs called beta interferons don’t do much to stop the disease from getting worse. Now, new research appears to back them up.
A study from researchers at the University of British Columbia and the UBC Hospital MS Clinic and Brain Research Centre found no strong evidence that the drugs had much of an impact on the long-term progression of the disease.[/QUOTE]
[QUOTE]For the study, the team looked at the health records of 2,656 British Columbia patients between 1985 and 2008. They included those with MS who were treated with beta interferons, as well as untreated MS patients.
The team reports in the Journal of the American Medical Association that beta interferons were not linked to a significant slowdown in disability progression in the patients.
The authors say while they could find little proof that the drugs had much impact on slowing the disabling effects of MS over time, the medications might still hold some benefits for patients.
"We know that this class of drugs is very helpful in reducing relapses, which can be important to patients,” study co-author Helen Tremlett said in a statement.[/QUOTE]
[URL="http://www.ncbi.nlm.nih.gov/pubmed/2279 ... t=Abstract"][U]Pubmed publicatie[/U][/URL]: Association between use of interferon Beta and progression of disability in patients with relapsing-remitting multiple sclerosis.
MS medicatie
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Marsei
Marie over dit onderzoek
Marie over dit onderzoek
Van Marie op [URL="https://www.facebook.com/notes/ccsvi-in ... 5214837211"][U]FB[/U][/URL]: The interferon problem
[QUOTE]This week has shown the release of work by Helen Tremlett of University of British Columbia's Therapeutics Initiative. The therapeutics initiative can be thought of as a kind of "consumers reports" for drugs. They evalaute claims and studies done by industry without any money or input from that industry.
Dr Tremlett's study says that interferon drugs do not slow progressive losses in function even though they reduce relapses. They evalauted this by looking at the records of thousands of people seen in MS clinics in Canada. They compared people treated with interferon with those who qualified for treatment but chose no treatment. What made this especially interesting is they also compared to people from former decades who would have qualified for treatment but didn't get the drug because it was not out yet. This gave two comparator groups, a current one and a historical one.
They found no significant difference between groups when looking at the percentage that progressed to an EDSS 6 (needing a cane or brace for walking). In all groups a similar percentage progressed to the EDSS 6 within 15 years from diagnosis.[/QUOTE]
[QUOTE]Here are a couple other papers suggesting interferon makes little difference to progressive disease.
[URL="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2787922/"][U]Risk Sharing Scheme[/U][/URL]
[URL="http://www.ncbi.nlm.nih.gov/pubmed/22258960"][U]Interferon in SPMS[/U][/URL]
[URL="http://www.thelancet.com/journals/lance ... 3/fulltext"][U]Years of Interferon[/U][/URL][/QUOTE]
[QUOTE]What is interesting is that the Tremlett paper explains [B]why[/B] some research seems to support the idea that interferons make a big difference in progression for MS patients. She talks about what went wrong in these other studies here.
"Previous postmarketing studies have suggested a positive association between interferon beta and MS disability outcomes.4-10,30 However, conducting adequately controlled longitudinal observational studies is challenging, and [B]many such studies have faced methodological issues[/B]. One of the larger studies to date, from 2 Italian centers,10 was susceptible to immortal time bias13,15 because of differing baselines for the treated and untreated cohorts. The use of a propensity score method in that study10 could not address immortal time bias. [B]An independent reanalysis found no apparent beneficial association with interferon beta treatment once this bias was considered."[/B]
Wow! A second researcher actually did the bias correction on a published study and suddenly the study conclusion was flipped on its head showing no benefit.
This demonstrates that HOW the researcher applies statistical analysis makes all the difference to the conclusion. By excluding some people's data or jiggering the groups (such as that I called out in my previous note) it is possible to make something that is ineffective look better than it is.
Dr Tremlett's study went out of its way to look at how bias influenced other papers in this area and to make sure their fresh analysis was free from these mistakes.[/QUOTE]
Van Marie op [URL="https://www.facebook.com/notes/ccsvi-in ... 5214837211"][U]FB[/U][/URL]: The interferon problem
[QUOTE]This week has shown the release of work by Helen Tremlett of University of British Columbia's Therapeutics Initiative. The therapeutics initiative can be thought of as a kind of "consumers reports" for drugs. They evalaute claims and studies done by industry without any money or input from that industry.
Dr Tremlett's study says that interferon drugs do not slow progressive losses in function even though they reduce relapses. They evalauted this by looking at the records of thousands of people seen in MS clinics in Canada. They compared people treated with interferon with those who qualified for treatment but chose no treatment. What made this especially interesting is they also compared to people from former decades who would have qualified for treatment but didn't get the drug because it was not out yet. This gave two comparator groups, a current one and a historical one.
They found no significant difference between groups when looking at the percentage that progressed to an EDSS 6 (needing a cane or brace for walking). In all groups a similar percentage progressed to the EDSS 6 within 15 years from diagnosis.[/QUOTE]
[QUOTE]Here are a couple other papers suggesting interferon makes little difference to progressive disease.
[URL="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2787922/"][U]Risk Sharing Scheme[/U][/URL]
[URL="http://www.ncbi.nlm.nih.gov/pubmed/22258960"][U]Interferon in SPMS[/U][/URL]
[URL="http://www.thelancet.com/journals/lance ... 3/fulltext"][U]Years of Interferon[/U][/URL][/QUOTE]
[QUOTE]What is interesting is that the Tremlett paper explains [B]why[/B] some research seems to support the idea that interferons make a big difference in progression for MS patients. She talks about what went wrong in these other studies here.
"Previous postmarketing studies have suggested a positive association between interferon beta and MS disability outcomes.4-10,30 However, conducting adequately controlled longitudinal observational studies is challenging, and [B]many such studies have faced methodological issues[/B]. One of the larger studies to date, from 2 Italian centers,10 was susceptible to immortal time bias13,15 because of differing baselines for the treated and untreated cohorts. The use of a propensity score method in that study10 could not address immortal time bias. [B]An independent reanalysis found no apparent beneficial association with interferon beta treatment once this bias was considered."[/B]
Wow! A second researcher actually did the bias correction on a published study and suddenly the study conclusion was flipped on its head showing no benefit.
This demonstrates that HOW the researcher applies statistical analysis makes all the difference to the conclusion. By excluding some people's data or jiggering the groups (such as that I called out in my previous note) it is possible to make something that is ineffective look better than it is.
Dr Tremlett's study went out of its way to look at how bias influenced other papers in this area and to make sure their fresh analysis was free from these mistakes.[/QUOTE]
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neuron
Interferon
Interferon
Waarom staat dit topic in MS anders bekeken en niet in MS regulier?
Een belangrijke flessenhals van MS onderzoek is het gebrek aan MS patiënten.
Al die MS patiënten die interferon gebruiken zijn over het algemeen niet beschikbaar voor ander onderzoek.
Zij zijn dus niet beschikbaar voor andere mogelijk succesvollere middelen.
.
Waarom staat dit topic in MS anders bekeken en niet in MS regulier?
Een belangrijke flessenhals van MS onderzoek is het gebrek aan MS patiënten.
Al die MS patiënten die interferon gebruiken zijn over het algemeen niet beschikbaar voor ander onderzoek.
Zij zijn dus niet beschikbaar voor andere mogelijk succesvollere middelen.
.
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neuron
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Marsei
UBC study observes natural improvement in MS-related disability
UBC study observes natural improvement in MS-related disability
UBC study observes [URL="http://mssociety.ca/en/help/msupdates/m ... is+Society+"][U]natural improvement[/U][/URL] in MS-related disability
[QUOTE][B]Summary[/B]
A UBC research team collected on all MS patients with definite MS registered with an MS clinic in British Columbia between 1980 and 2004 (follow up to 2009) from the British Columbian MS database to examine naturally occurring improvements in disability scores (EDSS).
The team observed improvements and sustained improvements in EDSS scores at one and two year intervals in people who were not treated with disease-modifying therapies. This finding suggests that more work is required to understand the underlying pathophysiology of MS, and the potential for therapeutic options geared at enhancing and prolonging this natural improvement. [/QUOTE]
UBC study observes [URL="http://mssociety.ca/en/help/msupdates/m ... is+Society+"][U]natural improvement[/U][/URL] in MS-related disability
[QUOTE][B]Summary[/B]
A UBC research team collected on all MS patients with definite MS registered with an MS clinic in British Columbia between 1980 and 2004 (follow up to 2009) from the British Columbian MS database to examine naturally occurring improvements in disability scores (EDSS).
The team observed improvements and sustained improvements in EDSS scores at one and two year intervals in people who were not treated with disease-modifying therapies. This finding suggests that more work is required to understand the underlying pathophysiology of MS, and the potential for therapeutic options geared at enhancing and prolonging this natural improvement. [/QUOTE]
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Sara
Long-Term Data Indicate Interferon Beta-1b Reduces the Risk of Death
Long-Term Data Indicate Interferon Beta-1b Reduces the Risk of Death
(met dank aan Angel@ voor het doorgeven)
[url]http://www.neurologyreviews.com/Article ... MI.twitter[/url]
Het gaat om een studie die in [B]1988[/B] gestart is, waarbij mensen door het lot een placebo of interferon Beta-1b (betaferon, in twee verschillende doseringen) kregen toebedeeld.
Die situatie heeft max. 5 jaar geduurd. Daarna is iedereen al of niet behandeld, naar eigen keuze.
Na 21 jaar zijn de gegevens van de deelnemers aan het onderzoek weer opgespoord, en er was een behoorlijk verschil in overleving:
van de placebo-groep waren bijna twee keer zoveel mensen overleden als van de beide behandelde groepen. Verreweg de meeste (78%) van de sterfgevallen waren MS-gerelateerd.
In het licht van de twijfel over het effect van de remmers op de verslechtering van MS vind ik het een behoorlijk spectaculair resultaat. Wat vinden jullie?
(met dank aan Angel@ voor het doorgeven)
[url]http://www.neurologyreviews.com/Article ... MI.twitter[/url]
Het gaat om een studie die in [B]1988[/B] gestart is, waarbij mensen door het lot een placebo of interferon Beta-1b (betaferon, in twee verschillende doseringen) kregen toebedeeld.
Die situatie heeft max. 5 jaar geduurd. Daarna is iedereen al of niet behandeld, naar eigen keuze.
Na 21 jaar zijn de gegevens van de deelnemers aan het onderzoek weer opgespoord, en er was een behoorlijk verschil in overleving:
van de placebo-groep waren bijna twee keer zoveel mensen overleden als van de beide behandelde groepen. Verreweg de meeste (78%) van de sterfgevallen waren MS-gerelateerd.
In het licht van de twijfel over het effect van de remmers op de verslechtering van MS vind ik het een behoorlijk spectaculair resultaat. Wat vinden jullie?