///////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////
***********************************************************************************
CCSVI - research so far and next steps
So far, many studies have been published looking
at how prevalent CCSVI is in people with MS, and
also looking at the effects of treatment for CCSVI. Although none of the
studies have been conclusive to date, more research is constantly being
published that will shine a light on the potential relationship between CCSVI
and MS.misaligned Atlas
Studies on prevalence
Many studies looking at the link between CCSVI and MS have been published. Some of these studies show a strong link between CCSVI and MS, and others show no link. This is likely to be caused by:- the differences in techniques used to detect CCSVI
- different study sizes
- the way the study was conducted.
Buffalo study
One of the largest studies to date on the prevalence of CCSVI was carried out in Buffalo NY.500 people were scanned by doppler scanning methods to detect signs of CCSVI:
- 56.1 per cent of 289 people with MS showed signs of CCSVI
- 22.7 per cent of 163 people without MS (healthy participants) also showed signs of CCSVI
- 38.1 per cent of 21 people with clinically isolated syndrome showed signs of CCSVI
- 42.3 per cent of 26 people who had other neurological conditions showed signs of CCSVI
1000 additional participants will now be examined for signs of CCSVI by more advanced screening methods in the second stage of the study, to get a more accurate picture of the prevalence of CCSVI in people with and without MS.
Based on these results, a small clinical trial involving 30
people with CCSVI is underway.
Italian study
Another large study looking at 1165 people with MS, 376 healthy volunteers and 226 people with other neurological conditions reported back in October 2012.CCSVI was found in:
- 3.26% of people with MS
- 2.13% of healthy volunteers
- 3.1% of people with other neurological conditions
Seven key NMSS funded CCSVI studies
In June 2010, the National MS
Society and the MS Society of Canada announced $2.4 million of support for seven
new research projects focusing on the role of CCSVI in MS.
Results from these seven key studies have started to be published.Texas study
Researchers from the University of Texas Health Science Centre at Houston used various neurosonography techniques to measure blood outflow from the brain to establish whether any of the participants in the study fulfilled the criteria for CCSVI. As part of their study they replicated the ultrasound methods used in the original studies which identified CCSVI in people with MS.Researchers assessed CCSVI in:
- 206 people with MS
- 70 people without MS
Canadian study
Researchers from the University of British Columbia and the University of Saskatchewan in Canada used ultrasound techniques and catheter venography - as used in the original CCSVI studies - to ascertain whether the study participants had CCSVI.177 people took part in the study (79 with MS, 55 of their siblings and 43 unrelated people who didn’t have MS) across three different centres in Canada.
Using catheter venography the researchers found that the following fulfilled criteria for CCSVI:
- 2% of people with MS
- 2% of their siblings
- 3% of unrelated people without MS
- 44% of people with MS
- 31% of their siblings
- 45% of unrelated people without MS
Interventional studies
In addition to studies on prevalence, there have also been a few small scale clinical trials looking at the safety and effectiveness of treatment of CCSVI on people with MS.
These studies focused mainly on
safety of the treatment. They also looked at things like relapse rate, disability status
and also measured lesions in the brain on an MRI machine, but these studies
were open labeled, meaning that placebo effects were not
accounted for. It remains difficult to draw firm conclusions on the potential
risks and benefits of CCSVI treatment in people with MS without doing larger,
more controlled studies.
There are a number of studies that have looked at the risk of treatment for
CCSVI. Some complications that have been described are:- developing clots in the vein
- arrhythmias (disruptions to the heart beat and rhythm)
- vein dissection (separation of the vein)
- in-stent thrombosis (bleeding at the site of stent placement)
- vein rupture
- groin hematoma (collection of blood outside the blood vessel).
In May 2012 the US Food and Drug
Administration (FDA) issued a safety communication on CCSVI which
mentions reports of adverse events associated with treatment for CCSVI.
Larger randomised controlled trials looking at
the safety and effectiveness of treatments for CCSVI in people with MS will
hopefully give us a more accurate picture of the potential risks and benefits of
treatment for CCSVI.
Until then, we do not recommend that people seek treatment for CCSVI outside
of a properly regulated clinical trial.
Page tagged with:
No comments:
Post a Comment