BOTA BORRELIA – SVENSKA PROFESSORER GÖR BORT SIG I AFTONBLADET OCH DN

ANFANG”Den som mår dåligt efter en trolig borreliainfektion blir inte bättre av en längre antibiotikabehandling, visar en ny studie. Dags att ge patienterna klara besked, tycker infektionsprofessorn Björn Olsen.”

Det är ingressen till den senaste i raden av artiklar som ska tjäna som åtgärd för att stävja ”folkupproret” i sociala medier, som dessutom enligt en barnläkare, är konspirationsteorier smittsamma via nätet, nämligen existensen av och engagemanget kring ”kronisk borrelia”

Lång behandling hjälper inte vid borreliabesvär

conspiracy

I Aftonbladet går Professorn Lars Hagberg ut och sällar sig i ledet.

ALLA MEDIA (UTOM EXPRESSEN, tack för det) FÖLJER MED I DREVET:
SvD,  P4 SR,  SVT

DET BEVISAR TVÅ SAKER.

Vi har inkompetent media och vi har inkompetenta Professorer.

Vi börjar med faktarutan i DN:

Fakta. Borrelia behandlas med antibiotika
  • Varje år smittas ungefär 10 000 personer i Sverige av borrelia.
  • Borrelia är en bakterieinfektion som sprids via fästingar.
  • Ett tecken på borrelia är ett stort rött märke där man blivit biten. Andra tecken på borrelia är huvudvärk, trötthet samt led- eller muskelvärk. Värken är oftast kortvarig.
  • I mer sällsynta fall kan personen få neuroborrelios, då nervsystemet påverkas. Det är vanligare hos barn än hos vuxna.
  • Det går inte att vaccinera sig mot borrelia. Behandling är antibiotika i 10-14 dagar.

Källa: 1177.se.

Sanningen rapporterar inga källor i Sverige trots att fakta finns hos SCANDTICK

Jag vänder mig till Broderfolkets media. De törs säga som det är:

f

Ok det var svensk journalism i ett nötskal – Nu över till det som ska vara intelligentian i Sverige, nämligen de lärde, Professorerna Hagberg och Olsén.

Olsèn bedriver forskning i Uppsala. Hur får man pengar till forskning om man redan vet svaret? Han leder ju en studie i Uppsala och begär pengar av samhället. Studien borde ju alltså stoppas eftersom han redan säger sig veta svaret. Det är ju fusk att kräva pengar om man inte är neutral som forskare.

Vem anmäler honom?

Nu kommer jag redovisa det som VERKLIGEN finns att finna om dessa braskande rubriker för den som VILL rapportera sakligt och ge FULLA bilden av vad detta handlar om, och talar för oss som detta påverkar handgripligen och direkt i form av lidande och spe:

VI BÖRJAR MED ORIGINALARTIKELN SOM DETTA NYHETSÄVENTYR BOTTNAR I:

Study: Prolonged Antibiotic Treatment Gave No Relief For Lasting Lyme Symptoms

UTDRAG UR ARTIKELN:

”Years after a standard two-week course of antibiotics against Borrellia burgdorferi or closely related organisms that cause the disease, these patients remain exhausted and foggy-headed. They suffer from chronic aches and pains and poor sleep.”

”In the last decade and a half, medical societies and some patient groups have foughtover how to treat these people and also over the reasons why they don’t get better.

Some doctors and guidelines recommend long-term antibiotic treatment for these Lyme disease patients. The National Institutes of Health and the Infectious Disease Society of America maintain, however, that prolonged antibiotics use doesn’t help, and advise doctors to limit antibiotics to the initial course.”

”At the end of the trial, no group of patients did better than the other. ”They were not helped by prolonged antibiotic treatment,” says Dr. Bart-Jan Kullberg, a senior author on the study and an infectious disease researcher at Radboud University in the Netherlands.

The study already has detractors. ”You do a lousy study that’s designed to fail, and you get a failed study. And that’s basically what this is,” says Dr. Raphael Stricker, a board member of the International Lyme and Associated Diseases Society , or ILADS, which advocates for the long-term use of antibiotics therapy.””

Those arguments don’t wash with Dr. Paul Auwaerter, an infectious disease specialist at the Johns Hopkins University School of Medicine. Even if there is a persistent infection, Auwaerter says, ”It doesn’t look like the extra antibiotics help them improve any faster.” Instead, Auwaerter says the needless use of the drugs raises the risk of developing antibiotic resistance in bacteria and other infections in individual patients. ”There’s a growing interest to reserve [antibiotics] for times they truly have documented benefit rather than conjecture.”

Auwaerter says Kullberg’s study is well done, and its critics are ignoring scientific evidence. ”The notion that the infection is difficult to eradicate with antibiotic therapy is not well supported by scientific evidence,” he says. In a 2011 editorial in The Lancet Infectious Diseases, Auwaerter and coauthors criticized organizations including ILADS of creating ”a parallel universe of pseudoscientific practitioners, research, publications and meetings.”

”Stricker argues that that mainstream professional societies are ignoring these patients’ needs. ”They’re horribly sick,” he says. ”They need decent treatment. Unfortunately, this study is going to be misinterpreted to say there is no treatment for these patients.”

But Auwaeter says the reason why these patients are still sick is complicated, and treatment shouldn’t involve antibiotics for months or years. ”It’s unnerving to both physicians and patients because nobody likes having something that we don’t understand.” He says the message that patients just need more antibiotics is appealing, but that it represents a false hope.”

Dr Stricker och undertecknad på NorVect

Dr Stricker och undertecknad på NorVect 2015

SJÄLVA STUDIEN

Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease

Anneleen Berende, M.D., Hadewych J.M. ter Hofstede, M.D., Ph.D., Fidel J. Vos, M.D., Ph.D., Henriët van Middendorp, Ph.D., Michiel L. Vogelaar, M.Sc., Mirjam Tromp, Ph.D., Frank H. van den Hoogen, M.D., Ph.D., A. Rogier T. Donders, Ph.D., Andrea W.M. Evers, Ph.D., and Bart Jan Kullberg, M.D., Ph.D.

N Engl J Med 2016; 374:1209-1220March 31, 2016DOI: 10.1056/NEJMoa1505425

strutting birds

 NU TILL KRITIK AV NÄMNDA STUDIE OCH DÄRMED OCKSÅ PROFESSORERNAS KOMPETENS:

Jag lämnar ordet till en BLOGG och kamp-kollega, en så kallad ”Lymewarrior” BETYDLIGT mer kompetent än våra herrar Hagberg och Olsén, tycks det som.

LORRAINE JOHNSON

30 MAR 2016

LYMEPOLICYWONK: Chronic Lyme European PLEASE Trial—You know it’s spin when treatment “success” is called “failure”?

Today a widely anticipated clinical trial on chronic Lyme disease from Europe called PLEASE was published in the New England Journal of Medicine (NEJM).  The press has given the trial a twenty trumpet salute with a MedPage headline reading “Long-Term Antibiotics Fail Again in Lyme Disease–Focus on Lyme and antibiotics for persistent symptoms called unhelpful.”  Here’s the thing—the findings of the study actually support retreatment.  What gives?

This study found that all patient groups improved with IV Rocephin/ceftriaxone and there were very few serious adverse events associated with treatment. So how can the authors or the press spin this trial as a treatment failure.  It’s all in how you define success.

Here are the key points:

  1. The study found clinically important improvement in all patient groups after two weeks of IV Rocephin.
  2. Some patients also received oral antibiotics after the IV treatment—these patients did not do better than those who only received IV Rocephin.
  3. There were very few serious adverse events.
  • 9 patients out of 205 (3.2%) had a serious adverse event
  • 5 of the serious adverse events were related to IV Rocephin.
  • 4 of the these were drug allergies. (Rocephin is related to penicillin, which has a higher rate of allergic reactions.)
  • No catheter (IV line) infections occurred.

Other important points to note:

  • Clinically important improvement was considered to be 3 points improvement on the SF-36 (which measures quality of life). The mean improvement was 4.6 points!  (Note the Klempner trial has been criticized for requiring 2 times this rate of improvement to qualify as treatment success.)
  • There was no placebo because it was deemed to be unethical not to treat patients who may be infected. Because the study was designed without a placebo, treatment response of the three groups treated with IV Rocephin cannot be compared to patients who did not receive treatment.
  • These patients are very sick. At baseline, patients had a poor quality of life as measured by the SF-36. (50 is considered normal. These patients were 32.)
  • This is a study of Lyme disease in Europe, which is caused by a different strain of Borrelia—which has a different course of illness than US strains.

How should we define success?  These authors were comparing 2 weeks of IV Rocephin against 2 weeks of IV Rocephin followed by oral antibiotics. They found no difference between those who received additional oral antibiotics and those who did not. So maybe the oral antibiotics aren’t adding much or maybe they were the wrong oral antibiotics or maybe they weren’t given long enough.  Who knows?

The fact is that all of the patient groups received IV Rocephin and all groups had clinically important improvement.  Shouldn’t that be the headline?

I hate to say the authors were mealy mouthed in their analysis, but let me provide their quotes and a translation free of spin:

At the 14-week visit at the end of the treatment period, the mean SF-36 physical component summary score had improved significantly from baseline regardless of the study group assignment, but quality of life remained below that of the general population.

This means that patients improved (actually significantly) but were not yet well.  This will not surprise Lyme patients—

Whether improvement in the SF-36 physical component summary score at the end of the treatment period is a beneficial effect of shorter term antibiotic therapy or a nonspecific effect caused by the low level of baseline functioning, expectations associated with treatment, or placebo effects remains unclear, because all the patients had received 2 weeks of open-label antibiotics before entering into the longer-term randomized study-drug or placebo phase.

This means all groups received IV Rocephin and all groups had significant improvement.  The study did not include a placebo by design.  (Yet, to prove cause and effect, trials need to have some patients who do not receive any treatment or who are given a placebo.) But this does not mean that treatment with Rocephin did not result in improvement.  It means they didn’t measure this.

For those who want the historic context for this article, in 2001 the NEJM first published a study by Klempner which has been used to deny Lyme patients treatment for the past 15 years. That study also was published to fanfare, with headlines reading “Chronic Lyme Disease Symptoms Not Helped by Intensive Antibiotic Treatment”.  A later critique of the Klempner trial pointed to the premature termination of the trial before reaching full recruitment. The critique by DeLong and colleagues found that the measure of success (7-9 points of improvement on the SF-36) was far too high a mark to set for success. (Note in the PLEASE study, success was set at 3 points based on a pilot study of the minimal clinical improvement unit.) Klempner, who now sits on the editorial board of the NEJM is believed to have helped grease the skids for the publication of this study—which pays homage to his previous work.

The LYME POLICY WONK blog is written by Lorraine Johnson, JD, MBA, who is the Chief Executive Officer of LymeDisease.org. You can contact her at lbjohnson@lymedisease.org. On Twitter, follow her @lymepolicywonk.  If you have not signed up for our patient centered big data project, MyLymeData, please register now.

References:

Berende A, ter Hofstede HJM, Vos FJ, van Middendorp H, Vogelaar ML, Tromp M, et al. Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease. New England Journal of Medicine. 2016;374(13):1209-20. Available from: http://www.nejm.org/doi/full/10.1056/NEJMoa1505425.

National Institute of Allergy and Infectious Disease. Clinical Alert: Chronic Lyme disease symptoms not helped by intensive antibiotic treatment. June 12, 2001.

Klempner M, Hu L, Evans J, Schmid C, Johnson G, Trevino R, et al. Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease. The New England journal of medicine. 2001 Jul 12:85-92. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11450676.

Delong AK, Blossom B, Maloney E, Phillips SE. Antibiotic retreatment of Lyme disease in patients with persistent symptoms: A biostatistical review of randomized, placebo-controlled, clinical trials. Contemp Clin Trials. 2012 Aug 19. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22922244.

Walsh, N. “Long-Term Antibiotics Fail Again in Lyme Disease–Focus on Lyme and antibiotics for persistent symptoms called unhelpful. ”http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/57044?isalert=1&uun=g479078d4949R5575556u&xid=NL_breakingnews_2016-03-30

Related Posts:

  1. LYMEPOLICYWONK: New Study Reveals Fatal Flaws in NIH Klempner Trial Statistical Analysis. Is this Error Human, Incompetence or Worse?
  2. LYMEPOLICYWONK: Embers Monkey Trials Part 2: Chronic Lyme Disease Treatment and Persistence
  3. LYMEPOLICYWONK: Growing Number Of Chronic Lyme Patients—Still No Government Action Plan?
  4. LYMEPOLICYWONK: Survey Results Published! Chronic Lyme Patients Suffer Poor Quality of Life and High Rates of Disability and Unemployment

LYME

Jag och många andra skrev in till TV4 med anledning av ”Soldoktorns” kränkande inslag (men censurerades) och jag misstänker att skrivelserna lär regna in till DN och Aftonbladet också gällande detta inslag, helt i presstutionens anda.

Men kritik, fakta och upprop kommer inte tystna för att ingen låter oss komma till tals.

Vi får bara finna nya egna vägar.

organise

Enklaste sättet att bli medlem är att sätta in medlemsavgiften på föreningens
Plusgirokonto 165 18 27-6 eller Bankgiro 5921-6770.
Årsavgiften för medlemskap är 300:- för fullt betalande medlem.
200:- för pensionärer, familjemedlem, stödmedlem och studerande.
Glöm ej att skriva namn, adress, telefonummer och eventuellt mailadress.
Det går bra att maila uppgifterna till foreningen@borrelia-tbe.se .
Om du har några frågor ang. medlemskap ring eller skicka ett mail.
Kontaktuppgifter finns under Kontakta Oss.

I övrigt så fortsätter kampen som förut.

Stå på er innan läkarna står på er!!

botaborreliaFBgruppen

(klicka på bilden)

Jag vill också påminna om petitionen för DR X;

http://www.skrivunder.com/radda_dr_kenneth_sandstrom_-_aka_dr_x

Petition för att stoppa Mats Reimers mobbande

FLER SOM REAGERAR PÅ DAGENS DEAL

(Denna blogg skriver jag som privatperson och INTE i min kapacitet som Ordförande, och de åsikter som redovisas är mina egna och representerar inte Föreningens hållning och i händelse av kritik, bör den åläggas undertecknad.)

Annonser
Det här inlägget postades i BOTA BORRELIA och har märkts med etiketterna , , , . Bokmärk permalänken.

3 kommentarer till BOTA BORRELIA – SVENSKA PROFESSORER GÖR BORT SIG I AFTONBLADET OCH DN

  1. Ping: Svar angående ”Lång kur mot borrelia hjälper inte” | Går kroniska sjukdomar att bota?

  2. langerbeck skriver:

    Jag noterade att studien bygger på förmodad borelia. Redan där faller studiens vetenskapliga värde och blir oanvändbar. För att ingå i studien skulle självfallet diagnosen borelia vara klar och inte förmodad!

  3. Ping: BOTA BORRELIA – ”PLEASE” (HELP US) REACTIONS | Bota Borrelia – Offer för sjukdom, inte samhället

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