PwMS in placebo end of trials are having less relapses
Re: PwMS in placebo end of trials are having less relapses
The 'placebo' effect is no different now than it was years ago. The point made by the author is that MS patients of today in the placebo groups are doing better overall than the patients in the placebo groups from decades ago and attributes this phenomenon to their overall better health. This statement confirms the concepts that good health is important to everyone, especially those of us with MS.
-
cheerleader
- Family Elder
- Posts: 5361
- Joined: Mon Sep 10, 2007 2:00 pm
- Location: southern California
Re: PwMS in placebo end of trials are having less relapses
Elliot---
You are correct.
that was my original point in writing this thread, and the point of Dr. Steinman, who I quoted in the original post. Treatment naive people w/MS are having less relapses than they were 10 years ago.
And this is due to better information on environmental links to vitamin D, B12, exercise, smoking cessation, stress reduction, sleep, UV rays, whole foods and lifestyle. It's not due to any medication/drug/pharma intervention.
This information is all over the internet---whether you follow Terry Wahls, Ashton and Matt Embry, Dr. Perlmutter or the Endothelial Health Program. People who are diagnosed with MS today have many more resources. And that's a good thing.
cheer
You are correct.
that was my original point in writing this thread, and the point of Dr. Steinman, who I quoted in the original post. Treatment naive people w/MS are having less relapses than they were 10 years ago.
And this is due to better information on environmental links to vitamin D, B12, exercise, smoking cessation, stress reduction, sleep, UV rays, whole foods and lifestyle. It's not due to any medication/drug/pharma intervention.
This information is all over the internet---whether you follow Terry Wahls, Ashton and Matt Embry, Dr. Perlmutter or the Endothelial Health Program. People who are diagnosed with MS today have many more resources. And that's a good thing.
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
-
centenarian100
- Family Elder
- Posts: 504
- Joined: Mon Apr 15, 2013 9:51 am
Re: PwMS in placebo end of trials are having less relapses
I think there is more to it than just lifestyle.
A lot of people with multiple sclerosis eat garbage and live an unhealthy lifestyle. This board attracts people who are particularly proactive.
Vitamin D is definitely a possible consideration.
Some other possible hypotheses:
1) People with more aggressive disease are now less likely to enter a clinical trials because there are already high effective disease modifying therapies for relapsing multiple sclerosis (tysabri, alembuzumab, rituxan), so why enter a clinical trial just to have 50% chance of receiving an agent which is likely less effective than readily available agents based on phase II results? In the original betaseron trials, ARRs were > 1. Now, the ARR (annualized relapse rated) in a placebo group is around 0.4. There are big differences in premorbid relapses, average age, and starting EDSS as well.
2) Now that there is more specialization in multiple sclerosis and more standard criteria for a relapse, relapses in clinical trials are more likely to be genuine and corroborated by actual changes on neurological exam. Worsening fatigue or generalized tingling will never be recorded as a relapse in modern trials.
3) Better MRI scans and clinical vigilance tends to lead to diagnosis of increasing mild cases of multiple sclerosis which may have a better prognosis. 0.5T MRI back in the 80s was garbage, and someone could develop optic neuritis and be told they don't have multiple sclerosis after a normal MRI. Now, the same patient could have a tiny Gd+ asymptomatic lesion on MRI and be diagnosed with multiple sclerosis.
All that aside, we should definitely do everything possible to maximize our chances of long term health.
A lot of people with multiple sclerosis eat garbage and live an unhealthy lifestyle. This board attracts people who are particularly proactive.
Vitamin D is definitely a possible consideration.
Some other possible hypotheses:
1) People with more aggressive disease are now less likely to enter a clinical trials because there are already high effective disease modifying therapies for relapsing multiple sclerosis (tysabri, alembuzumab, rituxan), so why enter a clinical trial just to have 50% chance of receiving an agent which is likely less effective than readily available agents based on phase II results? In the original betaseron trials, ARRs were > 1. Now, the ARR (annualized relapse rated) in a placebo group is around 0.4. There are big differences in premorbid relapses, average age, and starting EDSS as well.
2) Now that there is more specialization in multiple sclerosis and more standard criteria for a relapse, relapses in clinical trials are more likely to be genuine and corroborated by actual changes on neurological exam. Worsening fatigue or generalized tingling will never be recorded as a relapse in modern trials.
3) Better MRI scans and clinical vigilance tends to lead to diagnosis of increasing mild cases of multiple sclerosis which may have a better prognosis. 0.5T MRI back in the 80s was garbage, and someone could develop optic neuritis and be told they don't have multiple sclerosis after a normal MRI. Now, the same patient could have a tiny Gd+ asymptomatic lesion on MRI and be diagnosed with multiple sclerosis.
All that aside, we should definitely do everything possible to maximize our chances of long term health.