I would love to see the ARR calculations to turn out to be different and in a more favourable way than my calculation
- we will certainly have to wait for the raw numbers to be published.
But then again, I think the PR machine of the pharma-company would have explicitly highlighted how to correctly understand this 55% reduction in ARR IF! it was to be interpreted in a somehow great way - but we will see
Well, to its credit Genzyme was just reporting the results, without interpretation. I think your point was, based on these numbers, Campath doesn't look that great, especially compared to placebo. But putting the raw numbers aside, think about it like this - Rebif has shown some improvement in AAR over placebo (~30%). And Campath showed improvement over Rebif. So, compared to placbeo, Campath should show an even bigger improvement over AAR.
When it comes to the disability progression - imo - the idea of the CARE-MS 1 trial was to treat early diagnosed patients BECAUSE the privious experiences with Campath treatment seemd to indicate, that when patients receive Campath early in their disease course there was little/no more disability progresse and even some reversal of EDSS.
Patients with londer disease-duration did not respond so well.
So imo. the hope was that the neuro-degenerative part of MS - that potentially would be responsible for much of the permanent disability - will not occure if you were able to stop the inflamation process early in the disease course.
If thats correct then the group of patients recruited for the CARE-MS 1 trial should be the group of MS-Patients with the best response in regards to EDSS progression...
That's very true - one of the ideas behind early treatment with Campath is the theory that if you stop the inflammatory component of MS, you should be able limit disability and hopefully transition to SPMS. But, keep in mind, the disability numbers in this trial, like those for AAR, were done relative to Rebif treatment. So, it could be that both groups did well in terms of disability progression. It could be a natural history thing, or it could be that Rebif has a positive effect on disability progression in those treated early. If this was the case, it wouldn't mean that Campath doesn't reduce disability progression; it would just mean that it didn't show up in this trial.
Really, to test the early treatment hypothesis, you'd probably have to track those who received Campath vs. those who got nothing over a longer period of time. But this has its own set of ethical problems.....