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Re: Persistent mid back pain
SouthernMoss #279290 10/16/17 02:56 PM
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Originally Posted By: SouthernMoss
Originally Posted By: Thesnakejakw
You have stated large number of patients in several studies there has only been one study that showed it could possibly slow down progression in a 50 percent success rate. Unless there was a study done with thousands of people I lack the knowledge of seeing, how effective you think they are. I know people now that we're on biologics when they got the disease in 2000 such as remicade ect. It has done nothing for them as most of them progressed at a standard rate . You can't say it's not normal to have extreme pain as there are a high percent of people who do. I never stated my medications I take halt disease progression you also shouldn't say biologics help most people as that is a flat out lie, as a study of 12-24 years is not sufficient enough to say they help the majority the several studies were conducted with low patient numbers 300-600 and with not over 50 percent did it slow disease progression and in all the studies they say might and can just how you say may. leave the doctors out of this one just going on factual evidence and not cult medicine proof.


Please cite your sources. Otherwise, your remarks are just as unreliable as you claim NotMeToo's to be.



I shouldn't have to cite sources when you can look this information up and find out your self. All studies with biologics of what I seen on this site and some basic internet searches revealed only small studies , and in our world 12-24 years is not enough to claim it's going to work for most patients


Diagnosed 4+ months ago with as causes chest pain and severe back pain . Medications : methotrexate .6 per week in divided doses, Prednisone tapering off 2 5mg daily, folic acid mg daily, dicloymine for stomach pain and cramping , ranitidine 150mg twice daily and Prilosec 20mg extended release once daily , Carispodol (Soma) 350mg 5 times daily , oxycodone 10mg every 4 hours as needed
Re: Persistent mid back pain
Thesnakejakw #279291 10/16/17 03:20 PM
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Originally Posted By: Thesnakejakw
I know people now that we're on biologics when they got the disease in 2000 such as remicade ect. It has done nothing for them as most of them progressed at a standard rate .


How many people are you talking about? I know people who have taken biologics for 15 years or more and have NOT progressed at a standard rate.

Quote:
You can't say it's not normal to have extreme pain as there are a high percent of people who do.


Give me a percentage. I can't find anything to back up your claim.

Quote:
you also shouldn't say biologics help most people as that is a flat out lie, as a study of 12-24 years is not sufficient enough to say they help the majority the several studies were conducted with low patient numbers 300-600 and with not over 50 percent did it slow disease progression and in all the studies they say might and can just how you say may. leave the doctors out of this one just going on factual evidence and not cult medicine proof.


Your post is hard to read because of the run-on sentences and lack of punctuation, but you seem to be saying that you don't believe studies that don't include thousands of people. That's certainly within your right. However, just because you don't believe them doesn't make them untrue. And when you call someone a liar, you need to back that up with proof. I have looked for evidence that proves the studies are wrong and have been unable to find anything. Please help me out here.


Ginny - 58 year old female
Dx with USpA in March 2013; changed to AS in July 2015
Iritis and Scleritis, both currently in remission
unicompartmental knee replacements: right-June 2014, left-Aug 2018
MTX, Humira, Cyclobenzaprine, plus Celebrex as needed
Supplements: Folic Acid, Vitamin A, Vitamin D, Calcium, Fish Oil, Culturelle probiotic, Melatonin (as needed)
Re: Persistent mid back pain
PSO1957 #279296 10/16/17 10:27 PM
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There is plenty of evidence that anti-TNFs reduce the odds of progression if you look on PubMed. Here is one such study:

TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort
Abstract
Objectives to analyse the impact of tumour necrosis factor inhibitors (tnFis) on spinal radiographic progression in ankylosing spondylitis (AS).
Methods patients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow- up and radiographic assessments every 2 years were included. radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. the relationship between tnFi use before a 2-year radiographic interval and progression within the interval was investigated using binomial generalised estimating equation models with adjustment for potential confounding and multiple imputation of missing values. Ankylosing Spondylitis disease Activity Score (ASdAS) was regarded as mediating the effect of tnFi on progression and added to the model in a sensitivity analysis.

Results A total of 432 patients with AS contributed
to data for 616 radiographic intervals. radiographic progression was defined as an increase in ≥2 mSASSS units in 2 years. Mean (Sd) mSASSS increase was 0.9 (2.6) units in 2 years. prior use of tnFi reduced the odds of progression by 50% (or 0.50, 95% CI 0.28 to 0.88) in the multivariable analysis. While no direct effect of tnFi on progression was present in an analysis including time-varying ASdAS (or 0.61, 95% CI 0.34 to 1.08), the indirect effect, via a reduction in ASdAS, was statistically significant (or 0.75, 95% CI 0.59 to 0.97).

Conclusion TNFis are associated with a reduction of spinal radiographic progression in patients with AS. this effect seems mediated through the inhibiting effect of tnFi on disease activity

Re: Persistent mid back pain
SouthernMoss #279298 10/17/17 02:03 PM
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Diagnosed 4+ months ago with as causes chest pain and severe back pain . Medications : methotrexate .6 per week in divided doses, Prednisone tapering off 2 5mg daily, folic acid mg daily, dicloymine for stomach pain and cramping , ranitidine 150mg twice daily and Prilosec 20mg extended release once daily , Carispodol (Soma) 350mg 5 times daily , oxycodone 10mg every 4 hours as needed
Re: Persistent mid back pain
Thesnakejakw #279299 10/17/17 02:05 PM
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Diagnosed 4+ months ago with as causes chest pain and severe back pain . Medications : methotrexate .6 per week in divided doses, Prednisone tapering off 2 5mg daily, folic acid mg daily, dicloymine for stomach pain and cramping , ranitidine 150mg twice daily and Prilosec 20mg extended release once daily , Carispodol (Soma) 350mg 5 times daily , oxycodone 10mg every 4 hours as needed
Re: Persistent mid back pain
SouthernMoss #279300 10/17/17 02:05 PM
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Diagnosed 4+ months ago with as causes chest pain and severe back pain . Medications : methotrexate .6 per week in divided doses, Prednisone tapering off 2 5mg daily, folic acid mg daily, dicloymine for stomach pain and cramping , ranitidine 150mg twice daily and Prilosec 20mg extended release once daily , Carispodol (Soma) 350mg 5 times daily , oxycodone 10mg every 4 hours as needed
Re: Persistent mid back pain
SouthernMoss #279301 10/17/17 02:06 PM
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Diagnosed 4+ months ago with as causes chest pain and severe back pain . Medications : methotrexate .6 per week in divided doses, Prednisone tapering off 2 5mg daily, folic acid mg daily, dicloymine for stomach pain and cramping , ranitidine 150mg twice daily and Prilosec 20mg extended release once daily , Carispodol (Soma) 350mg 5 times daily , oxycodone 10mg every 4 hours as needed
Re: Persistent mid back pain
PSO1957 #279302 10/17/17 02:07 PM
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Diagnosed 4+ months ago with as causes chest pain and severe back pain . Medications : methotrexate .6 per week in divided doses, Prednisone tapering off 2 5mg daily, folic acid mg daily, dicloymine for stomach pain and cramping , ranitidine 150mg twice daily and Prilosec 20mg extended release once daily , Carispodol (Soma) 350mg 5 times daily , oxycodone 10mg every 4 hours as needed
Re: Persistent mid back pain
PSO1957 #279305 10/17/17 02:15 PM
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Diagnosed 4+ months ago with as causes chest pain and severe back pain . Medications : methotrexate .6 per week in divided doses, Prednisone tapering off 2 5mg daily, folic acid mg daily, dicloymine for stomach pain and cramping , ranitidine 150mg twice daily and Prilosec 20mg extended release once daily , Carispodol (Soma) 350mg 5 times daily , oxycodone 10mg every 4 hours as needed
Re: Persistent mid back pain
Thesnakejakw #279311 10/18/17 03:45 PM
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I have to agree with Ginny that your post is very difficult to read. You seem to jump back and forth between topics - sometimes within the same run on sentence. Let's refocus on the topic. You made a statement that "You can also argue that biologics are just the same as muscle relaxers and narcotics as they are also not proven beyond a reasonable doubt that they do stop the disease there is only a chance that it will,". I was trying to point out that your comparison made no sense. Biologics have been extensively studied for both AS and other diseases. Muscle relaxers and narcotics have also been extensively studied, but not specifically for AS as there is no basis to believe that they do anything to control the disease process.

Perhaps you misunderstand the structure of clinical trials. When there is a scientific basis to believe that a drug may be affective at treating a specific medical issue, that drug enters clinical trials. Clinical trials are done in phases. Phase 1 studies involve 20 to 100 people. Phase 2 studies involve several hundred (200 to 300). Phase 3 studies involve several hundred to several thousand (300 to 2000) patients. Phase 4 studies - also known as post marketing studies also involve several hundred to several thousand participants. It is the norm to see clinical trial data for 300 to 600 people extrapolated to the population as a whole.

The biologics have been shown (through clinical trials and many years of patient use) to effectively reduce the signs and symptoms of AS. They have become the standard of care in treating AS and related diseases.
Here is a link to a PubMed listing of just some of the studies that have been done on Spondyloarthropathies and TNF inhibitors.
https://www.ncbi.nlm.nih.gov/pubmed/?term=Spondyloarthropathy%2C+TNF+inhibitors
Here is a PubMed list of studies of Spondyloarthropathies and Narcotics. Note there are only 4 - 3 since the '90's. None discuss efficacy of reducing inflammation, depressing cytokines, or slowing progression.
Here is a PubMed list of the 1 (yes 1) study of Spondyloarthropathies and muscle relaxants.
Equating the well studied class of medications that are the standard of care for a disease to some effectively unstudied medications (for AS) is simply ridiculous.

CONTINUED

*Edited to add: I'm not sure what happened to the links. Obviously I was having a great deal of difficulty posting. The site seems to have a problem with copy and paste and certain characters.
If you are interested, go to PubMed and search "Spondyloarthropathies and TNF inhibitors", etc for the articles.

Last edited by NotMeToo; 10/18/17 06:08 PM.

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