February 21, 2003
By Nicholas Regush
You can first read my Health News Analyzer Report #158 and decide for yourself what I actually said (in proper context) about drugs, multiple sclerosis and other chronic illnesses. Upon re-reading my missive of February 14 sent to an international subscription list, I thought I had stated everything just fine. But one recipient, my colleague, RFD columnist, Dr. Malcolm Kendrick, begs to differ with my assessment. Itís a good sign that at least one person read it. Thank-you.
As for Kendrickís article, which begins with a tiny "pop" at what I said, and an admission that he had to close his eyes and take a few deep breaths, let me suggest that anyone who calls himself a skeptic or likes to tilt at windmills, should NEVER close his eyes after reading a sentence from here or there. Iím told that it can either cause nose bleed or temporary confusion, or both. But by all means, take all the deep breaths you like, preferably at reasonable intervals.
Here is the objectionable sentence again, as Kendrick began with it in his note of objection to my health news analyzer:
"In fact, a thorough review of the medical literature shows that even during the first year of treatment, the overall reduction of symptoms is modest."
That is the conclusion of a review of studies published in The Lancet. Given the review process described in the paper, the conclusion makes sense to me, and apparently to a lot of other people who have indicated concern in recent years that the drugs used to treat MS are only modestly effective and that new approaches to the treatment of the neurodegenerative disease are badly needed.
What I still canít understand is the following sentence, but seemingly a pivotal one, from Kendickís little "pop" at me:
"Therefore to criticize a treatment for only causing a modest reduction in symptoms, when achieving this is actually impossible, seems a touch harsh to say the least."
Well, gee, thatís not what I wrote. (Check it yourself) The Lancet authors didnít either. They wrote that the drug treatments result in a slight reduction of the number of patients who have exacerbations during the first year of treatment.
But hey, never mind, letís not get totally bogged down in trivia. The key issue is: Are these beta interferons good treatments for MS? And how do we know?
In my Health News Analyzer report, my concern was focused largely on the longer-term effects of the treatments. I never said or even hinted that they shouldnít be used to treat MS. However, my point is that studies are needed to track people for longer term evaluations of the safety and efficacy of these drugs.
Kendrick believes MS may be difficult to track, given its unpredictable nature. Well, can we at least give it a try, especially given that the medical Establishment continues to put its ball so strongly in the beta-interferon court? Kendrick says it would cost drug companies hundreds of millions of dollars to run tests longer than two years. My heart bleeds for them (and Iím not even anti-drug industry because I, for one, truly do believe that some drugs actually work). But Kendrick goes on to suggest that if these drugs have a beneficial effect over the short-term, then they may keep on working beyond that time limit. Is this advocacy for a medical free-for-all? Why donít we use crystal balls for science?
Given that these drugs are used so widely, hyped so heavily by the drug industry and talked up by the sycophant media types who run press releases rather than do enterprise reporting, it seems to me that MS is a disease worth spending some money on, given the huge numbers of people involved and the unanswered questions about cause and treatment benefits. If, in fact, this route of drug prescription (use of beta-interferons) is to continue at the current clip, then it will be extremely important to find ways of doing longer studies, which I submit is not next to impossible as Kendrick implies. We do it for other conditions. Why not for MS? It might well be that this route of drug prescription is really a dead end. Weíll never know until we get better data.
I donít think that the typical MS patient would be satisfied to go on beta-interferon treatment and get only the benefit of an additional "two or three years of independent life." Maybe, thatís not terrible, but it isnít very good either.
Kendrick also seems to think that if the FDA says it only wants two-year studies, thatís the way to do business. The FDA? Please. This is an agency in such disrepair that any mention of its often-pathetic safety and efficacy guidelines for a wide range of drugs is beyond the scope of civil discussion.
I want to make it very clear, however, that after writing THE VIRUS WITHIN, (Dutton, NY) several years ago, which deals, in part, with MS, I became sadly aware of just how the MS medical and voluntary organization Establishments PREVENT the pursuit of new approaches to the disease.
Kendrick refers to inflammation in his piece as a vital signature of
MS, and I couldnít agree more that inflammation is important in the process
that destroys brain tissue. But that may only be a small part of the MS
puzzle. Unfortunately, with all the empire building that has gone on in
the MS Establishment, particularly in the last decade, research funds are
not going out as they should to try to find possible triggers (such as
viruses) for that inflammatory process. In fact, in THE VIRUS WITHIN, I
chronicled the work of two Milwaukee researchers who have published on
the possible role of HHV-6 (human herpes virus six) in the MS process.
Part of their story reflects the unwillingness of the MS Establishment
(and letís drag the drug companies into this cabal of immunologists, neurologists
and bureaucrats who sit together at "free lunches") to focus attention
on possible trigger mechanisms and new treatments ó largely because all
these little fiefdoms that have been created make a lot of dough for everyone.
Except the patient, of course.
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