The logic of GA

T
Eskyte I, Manzano A, Pepper G, Pavitt S, Ford H, Bekker H, Chataway J, Schmierer K, Meads D, Webb E, Potrata B.
Understanding treatment decisions from the perspective of people with relapsing remitting multiple Sclerosis: A critical interpretive synthesis.Mult Scler Relat Disord. 2018 Nov 17;27:370-377. doi: 10.1016/j.msard.2018.11.016.

BACKGROUND: Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system that mainly affects young adults. While there is no cure for MS, disease modifying treatments (DMTs) reduce the relapse rate and partial accrual of disability. More effective DMTs may have higher risks including life-threatening infections or secondary autoimmunity. The complexity and novelty of available treatments cause challenges for clinicians when prescribing treatments and for people with MS (PwMS) when deciding what trade-offs they are willing and ready to make.
OBJECTIVE: To explore the experience of people with relapsing remitting MS (PwRRMS) and their perspectives in choosing treatments.
METHODS: Critical interpretive synthesis was employed to review and synthesis the published literature. Eighty-three publications were selected in a multi-step systematic process.
RESULTS: Findings are presented in four interrelated areas: the influence of the clinical evidence-base in decision making; the meaning of DMT efficacy for PwRRMS; the influence of models of decision-making and information acquisition practices in PwRRMS; and the importance of psychosocial dimensions in DMT decision making. Synthesis of the findings revealed that alongside medical and individual reasoning, contextual circumstances play an important role in making treatment decisions.
CONCLUSION: This review identifies and explains the importance of diverse contextual circumstances (clinical, social, psychological) that are important for PwRRMS when making treatment decisions. The findings demonstrate the importance of eliciting, understanding and addressing such contextual factors.

I am from Yorkshire and must speak a different form of English as I just have no clue what this abstract really means. I disagree with the tennet that there is no cure, because if people are disease free as some people have been with the immune reconstitution therapies then maybe the c-word is here. Time will tell.

However, in making decisions on glatiramer acetate it must be limited side effects and perhaps lazy neurologists who don’t want to do any monitoring that are all important. Otherwise the glateriods would not be the number one best seller.

It can’t be based on efficacy, as they are probably the least efficacious group of treatments.
It can’t be because of convenience as you have to inject every day
It can’t be based on logic and mechanism as these were designed on a (in my opinion) false idea that myelin basic protein is the autoantigenic cause of MS, using data of dubious translational value, where it only really works well in animals when you mix the stuff with the adjuvants used to induce disease.

The regulators says “The mechanism(s) by which glatiramer acetate exerts its effects in patients with MS is (are) not fully elucidated. However, it is thought to act by modifying immune processes that are currently believed to be responsible for the pathogenesis of MS”



Eh!


Is this why GA has a “mechanism a month” ?



Because as each new mechanism comes along GA has to work via it.  

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MouseDoctor

5 comments

Leave a Reply to Klaus Schmierer Cancel reply

  • GA has a mechanism of the month so that TEVA and its shareholders can continue to profit off a drug that works very poorly in MS patients.

    It reduces relapses by a whopping 30% above placebo and has zero effect on disease progression. It does not matter its mechanism if it does not work and should never be prescribed to a new MS patient.

  • You have to hand this one to the regulators (and Teva) – Copaxone acts "by modifying immune processes that are currently believed to be responsible for the pathogenesis of MS" – perfectly adaptable to whatever new mechanism comes along – it's genius!

  • I fell out of sync with things when i could get pharmaceutical industry to do the studies that were

    really needed,which is looking to long term out comes where you reach a point where something

    really important was happening ,the like, the developing of progressive disease, could´nt get them to

    do it

    I could tell you that some (pharma employees) told me frankly “ why would we do this?”

    “We´re selling lots of drugs ,we`re making lots of money, doing that study could only be bad for us”

    “if it shows that does work ,than it will be right where we are right now”

    “If we show that it does´nt work we lost the whole ball game”

    There ´s almost no evidence that any of this drugs make a diference in the long term,

    what they do very cleverly is “leave the impression that its going to make a diference in the long

    run” with actually saying so

    Thats when the controversy begin ,because, when pressure was put on them 20 , 25 years ago

    to carry out the studies to make them longer and reach harder outcames, lets say time to needing a

    All they have to do was say: Ok you dont get the long term out come?

    No aproval

    And there is nothing more motivating for a pharmaceutical company than tell them their gonna have

    their licence for the drug jerked if they dont comply

    They never did it

    Professor :Georges Ebers

    • George Ebers needs to move out of the CRAB age, the landscape has changed.

      Neuros and PwMS bought the view that these agents are active… The ocrelizumab extension daya bangs home that many of you lose your reserve on these treatments.

      Works for a few.

  • I use GA because my neuro insists that it has "made positive effects on me", but, honestly, it's not the MS (by the course of itself) in me or the weak GA that are "MS under control".
    It's weird to use something that you really don't know how it works or what it can do…

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