IV n3 and n6 improves guttate
JRStern
1993 study, one has to wonder if it's been followed up (and how it
would work on psoriasis in general)
J.
JRStern
1998 study. Yup, plaque, too.
This sounds awfully easy to try, only be $10,000 cheaper than Amevive.
J.
evetsm
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9555791&dopt=Abstract
>
> 1998 study. Yup, plaque, too.
>
> This sounds awfully easy to try, only be $10,000 cheaper than Amevive.
>
> J.
You would wonder how results like these get buried without trace ? I
guess there is no money in fish oil these days or perhaps these
results are bogus but they still somehow survived the peer review
process by fluke ?
JRStern
>JRS...@gte.net (JRStern) wrote in message news:<3b66d43b...@news.gte.net>...
>> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9555791&dopt=Abstract
>>
>> 1998 study. Yup, plaque, too.
>>
>> This sounds awfully easy to try, only be $10,000 cheaper than Amevive.
>
>guess there is no money in fish oil these days or perhaps these
>results are bogus but they still somehow survived the peer review
>process by fluke ?
Amazing, ain't it?
How can we follow up on this? Just showing our local derms, ain't
gonna help (tho I suppose I will, next time I go, whenever that may
be). Can we forward it to the NPF for investigation?
It's this kind of stuff where even I, not usually a conspiracy fan,
start believing that it is indeed just a matter of a reactionary
medical establishment completely driven by a money-grubbing drug
industry, who couldn't make a buck on this.
Now, would HMOs benefit hereby? Would an infusion of EFAs be cheaper
and easier than a handfull of Neoral pills? Well, maybe, if the
ongoing monitoring were cheaper (and of course, if it worked!). But
HMOs are not in the business of investigating new treatments.
Are these infusions available today, or would they have to go through
an FDA approval process?
Inquiring and itchy minds want to know.
J.
Marvin Nelson
Sure an interesting study, my only thought was that I would have loved to
see them take the ones that weren't helped by the treatments and flip them
after a diet to deplete the omega 3 omega 6 in their systems.
The only thing I know to be aware of if giving oils intravenously is that
the EPA + DHA has shown to prevent ventricular fibulation in dogs, on the
omega 6 side most were also protective except AA in the absence of NSAIDs
would cause fibulation, it was also protective in prescence of NSAIDs. I
would sure hate to give someone a heart attack with AA.
Best Wishes,
Marv
"JRStern" <JRS...@gte.net> wrote in message
news:3b66d2ea...@news.gte.net...
>
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
DaveW
> You would wonder how results like these get buried without trace ?
Buried without a trace? Isn't it funny how PubMed carries it:
http://www.pinch.com/skinny?medline=9555791
And J. found it. And I've already posted a link to that study at
least twice in the last two years in this very newsgroup (and
more times elsewhere). Oh, yeah, that study is hidden away...
And hey, it's your old friend, E. Christophers! That researcher's
work on psoriasis is often suppressed, isn't it?
http://www.pinch.com/skinny?medline=christophers+E+psoria*
Of course, since you've been looking into psoriasis research for
four or five years now, it's actually surprising you didn't see
this when it was published just 3 years ago. How could you fail
bring this to the world's attention, Gary?
Anyway, just what are the "results like these?" Let's see, 37% of
the patients had a 50% or greater reduction in PASI score, after
(and this is an important consideration) 14 straight days of IV
infusions. This is compared to 23% who got a supposed placebo.
It's an okay therapy, but it's my no means earth-shakingly
revolutionary. Fumaric acid ester trials tended to report 50%
getting 50% improvement. Steroids tend to be even better.
One of the main things that's missing, of course, is long-term
follow-up. How long did these people keep the psoriasis at the
new, lower levels? Don't know, but I do know that if the length
of "remission" (such as it is) is short, this therapy will rarely
be used. Other, established therapies work better.
> I guess there is no money in fish oil these days or perhaps these
> results are bogus but they still somehow survived the peer review
> process by fluke ?
And you're right: there is no money in fish oils. That's harsh,
but it's the economic truth. As soon as you actually start trying
to use them as a treatment, they become a drug for which millions of
dollars need to be spent on a New Investigative Drug application,
and years more clinical study needs to be done before it'll get
approved for use for psoriasis, at least in the U.S. Who will be
able to even get a non-negative return on their multi-million dollar
investment when fewer than half the patients will get halfway better?
Who's going to pony up the bucks when it's almost a given that those
bucks won't come back, even one-for-one?
You can always move to a country where the requirements for medicines
are much lower, but it'd probably shave years off your lifespan. It's
a simple trade-off. What's more important to you: long total life or
higher quality of life right now?
And your absolute faith in the peer-review process is utterly
mystifying. Want to talk about homeopathy again? There's plenty
of bad science passing "peer review" in that field. Not that
these omega-3 results are in any way "bogus," they just say
that this therapy isn't all that wonderful.
- Dave W.
http://members.aol.com/psorsite/
JRStern
<flaxfo...@yahoo.com> wrote:
>Sure an interesting study, my only thought was that I would have loved to
>see them take the ones that weren't helped by the treatments and flip them
>after a diet to deplete the omega 3 omega 6 in their systems.
Or rebalance.
One or another study also talked about a "washout" period that should
have been longer, you need to baseline people, ... one preliminary
study can only show so much.
>The only thing I know to be aware of if giving oils intravenously is that
>the EPA + DHA has shown to prevent ventricular fibulation in dogs, on the
>omega 6 side most were also protective except AA in the absence of NSAIDs
>would cause fibulation, it was also protective in prescence of NSAIDs. I
>would sure hate to give someone a heart attack with AA.
I think that's pretty well understood as one of the factors, but the
entire EFA metabolic system is very complex and poorly understood.
I was surprised to see some of this lit, I had the impression there
wasn't even this much available, guess my time at the UCLA Med Library
wasn't spent on EFAs, I think I did that back in early Dovonex days.
Hey, officially, y'know, I'm a patient, not a physician or a
researcher, right? <g>
J.
JRStern
>> You would wonder how results like these get buried without trace ?
>
>Buried without a trace?
Dave, it's burried in plain sight, if it's not followed up on either
to support or debunk.
>And hey, it's your old friend, E. Christophers!
Wassup with that?
>Anyway, just what are the "results like these?" Let's see, 37% of
>the patients had a 50% or greater reduction in PASI score, after
>(and this is an important consideration) 14 straight days of IV
>infusions. This is compared to 23% who got a supposed placebo.
>
>It's an okay therapy, but it's my no means earth-shakingly
>revolutionary. Fumaric acid ester trials tended to report 50%
>getting 50% improvement. Steroids tend to be even better.
Steroids have known drawbacks. Of course, the high placebo score
makes the whole thing somewhat dubious, but this is often seen. More
studies would help.
>One of the main things that's missing, of course, is long-term
>follow-up. How long did these people keep the psoriasis at the
>new, lower levels? Don't know, but I do know that if the length
>of "remission" (such as it is) is short, this therapy will rarely
>be used. Other, established therapies work better.
Many different schedules could be tried. Maybe daily IV isn't
necessary to bring improvement in the first place. Maybe it could be
maintained at least somewhat by diet. Lots of maybes. And, we're
looking to add a new therapy to the list, not necessarily replace
everything else.
I was wondering what side-effects there might be generally from IV'ing
EFAs, same question you asked. OTOH, "established therapies" have
plenty of horrible side-effects already, so the bar is pretty high
there.
It is the (presumed) general harmlessness of the therapy in cases
where it might not work, that increases my interest in it. Same as
with the new monoclonals -- maybe they don't work even as well as
Neoral, but with far fewer side effects, I'd give up a few percent of
improvement. (OTOH then there's the cost and convenience, ...)
Most of all, if the effect is real, it should be better understood,
because that's how you get serious new approaches and results. THAT's
the real reason why it's upsetting to see a promising study lost,
ignored, orphaned, etc. And if we can say the same for others, well,
let's not lose track of those, either.
>You can always move to a country where the requirements for medicines
>are much lower, but it'd probably shave years off your lifespan. It's
>a simple trade-off. What's more important to you: long total life or
>higher quality of life right now?
Good question. Give me some numbers. Anyway, the issue is a bit of a
non sequiter.
>And your absolute faith in the peer-review process is utterly
>mystifying. Want to talk about homeopathy again? There's plenty
>of bad science passing "peer review" in that field.
Lots of bad science in all fields, that's why the process is as it is.
Sturgeon's Law: 80% of everything is s*it.
> Not that
>these omega-3 results are in any way "bogus," they just say
>that this therapy isn't all that wonderful.
Many days, I'd happily settle for just a little bit of wonderful. A
little cautious interest shouldn't hurt in such cases. That's all
we're saying.
J.
DaveW
>Dave, it's burried in plain sight, if it's not followed up on either
>to support or debunk.
J., given Gary's (Evetsm) penchant for conspiracy theories, I
answered his post in kind.
Besides which, there are lots of studies on omega-3 EFAs and
psoriasis published in mainstream medical journals. If the people
who are actively involved in psoriasis research have read the full
text (not a longshot) and decided to not run follow-up studies, then
there's probably a good reason - not a "suppression" reason.
>>And hey, it's your old friend, E. Christophers!
>
>Wassup with that?
One of the authors of that study, E. Christophers, not only defined
the terms "type I" and "type II" in relation to psoriasis (early vs late
onset), but also did the big German study Gary (Evetsm) is found
of citing which showed that psoriatics have a larger-than-average
chance of having type-II diabetes. Christophers is a damn good
psoriasis researcher. I was pointing this out to Gary in order to show
him that Christophers is very *un*likely to be "buried."
>Steroids have known drawbacks.
Every therapy that's well-studied has drawbacks of some sort.
>Of course, the high placebo score makes the whole thing somewhat
>dubious, but this is often seen. More studies would help.
Yes, they would. The placebo score, of course, is only "high" in
relation to the therapy under test. 37% percent on the "good stuff"
is a respectable (though on the low side) number. 20-something% is
fairly average for placebo.
>Many different schedules could be tried. Maybe daily IV isn't
>necessary to bring improvement in the first place. Maybe it could be
>maintained at least somewhat by diet. Lots of maybes. And, we're
>looking to add a new therapy to the list, not necessarily replace
>everything else.
Yeah, maybe. And yeah, we are looking to add something new to the
list, which is both safe *and* effective. If it's not effective when compared
to other therapies which are already on the list, then forget it. It's not
worth the time and labor. If it's safer, but not-quite-as-effective, then go
ahead and add it. This doesn't appear (to me) to be effective *enough*
to "make up" for any increase in safety.
>I was wondering what side-effects there might be generally from IV'ing
>EFAs, same question you asked. OTOH, "established therapies" have
>plenty of horrible side-effects already, so the bar is pretty high
>there.
Hmmm. Besides the alleged cancer risk (which is tiny at best), and
increased photosensitivity (which accompany many psoriasis therapies),
name one "horrible" side effect of coal tar, which has an efficacy rate
much higher than IV omega-3 EFAs.
There are some "established therapies" which don't have "horrible" side
effects.
>It is the (presumed) general harmlessness of the therapy in cases
>where it might not work, that increases my interest in it. Same as
>with the new monoclonals -- maybe they don't work even as well as
>Neoral, but with far fewer side effects, I'd give up a few percent of
>improvement. (OTOH then there's the cost and convenience, ...)
It's the "presumed" which gets to me.
>Most of all, if the effect is real, it should be better understood,
>because that's how you get serious new approaches and results. THAT's
>the real reason why it's upsetting to see a promising study lost,
>ignored, orphaned, etc. And if we can say the same for others, well,
>let's not lose track of those, either.
Abso-freaking-lutely!! I hope my posts haven't said, "oh, forget omega-
3 EFAs, they don't work." Because that wasn't my intent. Gary and,
to a lesser extent, Marv, have posited omega-3's as some sort of
"suppressed" psoriasis therapy. My point has been that they're
nothing of the sort. On the other hand, what research exists shows
that they're not all that wonderful. *Good* researchers have looked
into omega-3s at least once, and have shown that, at best, they have
a "modest" effect - given the current state of research.
So, my question is: should valuable *public* research dollars be spent
on even more follow-up testing of this therapy? Or should such
research await some sort of more-private funding? I have no problem,
personally, with my tax dollar or NPF dollar going towards further
further exploration of omega-3s in any form, as long as the research
is being done as bst it can be done. Double-blind, randomized, and
controlled. If it were up to me, I'd use inert dyes to make an IV
bag of saline look like a bag of omega-3s, rather than using the unproven
"placebo" of omega-6s. I don't think they've been shown to be an
uneffective treatment.
>Good question. Give me some numbers. Anyway, the issue is a bit of a
>non sequiter.
I don't have any numbers. And it's not a non-sequitor *if* you keep in
mind that Gary thinks the FDA is in the pocket of the drug companies.
Gary can either live under the system as it is now, *vote* to change it,
or move out. It's his choice, but he consistently whines about how
his own government is doing him wrong. It seems like he'd rather be
a "victim" of the FDA than actively working to fix the known problems.
If that's the case, he can move out of the U.S. because he's not doing
his part in the *process*.
>Lots of bad science in all fields, that's why the process is as it is.
>Sturgeon's Law: 80% of everything is s*it.
Yeah, but Gary consistently claims that if it winds up published in a
"peer-reviewed" journal, it must be the "truth". Even though the whole
peer-review process has been explained to him, Gary still apparently
thinks that reviewers have some sort of magical "truth detector." The
reality is that they tend to just check for consistency within the
proferred assumptions, because they *don't* know everything. They
are humans, like the rest of us.
In this case, the reviewers probably said, "well, omega-6s are
probably okay as a placebo - don't see any reason why they're
not." And as long as the rest of the *full* paper (don't forget that Gary
hasn't read the full text of any article he's cited) doesn't make any
gross contradictions with those assumptions, it'll pass muster and
be published.
Of course, the more obvious problem is that when Gary is shown
contradictory evidence in peer-reviewed journals, he tends to ignore
it instead of considering it the Gospel like his own cites.
>Many days, I'd happily settle for just a little bit of wonderful. A
>little cautious interest shouldn't hurt in such cases. That's all
>we're saying.
That's the main thing, J.: that's all I'm saying, too. Gary's interest
is *far* from "cautious," especially considering he doesn't even
have psoriasis. Gary finds tremendously weak connections and
promotes them as "perhaps" being of benefit to us psoriasis
sufferers, without ever being able to try them out himself. He
expects the people of this newsgroup to be his guinea pigs for
whatever his latest "breakthrough" happens to be.
On the other hand, because his grandmother had psoriasis, I
have and will defend Gary's right to post to this newsgroup. I
simply expect my right to reply to his (mostly) misinformation
and guesswork to be defended, too. "That's all we're saying"
applies just as much to me.
JRStern
>>Dave, it's burried in plain sight, if it's not followed up on either
>>to support or debunk.
>
>J., given Gary's (Evetsm) penchant for conspiracy theories, I
>answered his post in kind.
You perceive him as being unreasonable, so you responded in kind,
unreasonably? So, it would be better if I ignored any post where you
respond to him? Sorry, I didn't realize that was the game.
>Besides which, there are lots of studies on omega-3 EFAs and
>psoriasis published in mainstream medical journals. If the people
>who are actively involved in psoriasis research have read the full
>text (not a longshot) and decided to not run follow-up studies, then
>there's probably a good reason - not a "suppression" reason.
The question here was specifically about IV EFAs. The question is
exactly whether all the non-IV EFA studies are relevant or not, the
suggestion being that they are not.
>>>And hey, it's your old friend, E. Christophers!
>>
>>Wassup with that?
>
>One of the authors of that study, E. Christophers, not only defined
>the terms "type I" and "type II" in relation to psoriasis (early vs late
>onset), but also did the big German study Gary (Evetsm) is found
>of citing which showed that psoriatics have a larger-than-average
>chance of having type-II diabetes. Christophers is a damn good
>psoriasis researcher.
OK.
>>Steroids have known drawbacks.
>
>Every therapy that's well-studied has drawbacks of some sort.
Then it is not reasonable to say, "we have steroids and don't need to
do research on anything else".
>>Of course, the high placebo score makes the whole thing somewhat
>>dubious, but this is often seen. More studies would help.
>
>Yes, they would. The placebo score, of course, is only "high" in
>relation to the therapy under test. 37% percent on the "good stuff"
>is a respectable (though on the low side) number. 20-something% is
>fairly average for placebo.
Maybe following the amevive study, the control/placebo group is
allowed other therapies.
>>Many different schedules could be tried. Maybe daily IV isn't
>>necessary to bring improvement in the first place. Maybe it could be
>>maintained at least somewhat by diet. Lots of maybes. And, we're
>>looking to add a new therapy to the list, not necessarily replace
>>everything else.
>
>Yeah, maybe. And yeah, we are looking to add something new to the
>list, which is both safe *and* effective. If it's not effective when compared
>to other therapies which are already on the list, then forget it. It's not
>worth the time and labor. If it's safer, but not-quite-as-effective, then go
>ahead and add it. This doesn't appear (to me) to be effective *enough*
>to "make up" for any increase in safety.
This is unreasonable. We know the variability of treatment
effectiveness for p sufferers, and what little we do know of EFA
effects. At the least, a confirming study would be relatively cheap
and easy. At the best, it might look for some way to predict which
people would benefit from the treatment. That's the future of drug
therapies, matching the therapy to individual genomes.
>>I was wondering what side-effects there might be generally from IV'ing
>>EFAs, same question you asked. OTOH, "established therapies" have
>>plenty of horrible side-effects already, so the bar is pretty high
>>there.
>
>Hmmm. Besides the alleged cancer risk (which is tiny at best), and
>increased photosensitivity (which accompany many psoriasis therapies),
>name one "horrible" side effect of coal tar, which has an efficacy rate
>much higher than IV omega-3 EFAs.
Again, coal tar is so good, we shouldn't look for anything else? How
many people does coal tar clear? How many does it not? For those who
don't clear with just coal tar, or coal tar combined with everything
else known, we need a broader spectrum of treatments. Or are you
being purposely unreasonable with me?
>There are some "established therapies" which don't have "horrible" side
>effects.
Sure, pyramid hats.
>>It is the (presumed) general harmlessness of the therapy in cases
>>where it might not work, that increases my interest in it. Same as
>>with the new monoclonals -- maybe they don't work even as well as
>>Neoral, but with far fewer side effects, I'd give up a few percent of
>>improvement. (OTOH then there's the cost and convenience, ...)
>
>It's the "presumed" which gets to me.
Does it scare you that it might turn out to be valid?
>>Most of all, if the effect is real, it should be better understood,
>>because that's how you get serious new approaches and results. THAT's
>>the real reason why it's upsetting to see a promising study lost,
>>ignored, orphaned, etc. And if we can say the same for others, well,
>>let's not lose track of those, either.
>
>Abso-freaking-lutely!! I hope my posts haven't said, "oh, forget omega-
>3 EFAs, they don't work."
Well, looking back up at the thread title, let me remind you it's not
just 3's, and it's not topical use of EFAs, and it's not the ingestion
of EFAs, and the ineffectiveness of one EFA may not tell us anything
about another EFA. And, I am very much afraid that your posts do seem
to say that there is nothing here worth using or studying.
> Gary and,
>to a lesser extent, Marv, have posited omega-3's as some sort of
>"suppressed" psoriasis therapy.
As far as the average practicing derm in the U.S., they might just as
well be suppressed.
>My point has been that they're
>nothing of the sort. On the other hand, what research exists shows
>that they're not all that wonderful. *Good* researchers have looked
>into omega-3s at least once, and have shown that, at best, they have
>a "modest" effect - given the current state of research.
Again, I must say that my experience with EPO is so clear and
dramatic, in its limited way, that it is SHOCKING to me that it is not
a standard part of conventional medicine's equipment for treating this
disease. Maybe it only works at all for X%, but for that X% it is
dynamite. As I said above, the customization of treatments to
individual patients is the trend in high-tech medicine. It's supposed
to be the rationale for trained doctors being required to prescribe
treatments. That is, even traditionally, one-size-fits-all is not a
requirement for treatments. I do not see these sorts of
considerations fairly represented in your recent posts on this topic.
>So, my question is: should valuable *public* research dollars be spent
>on even more follow-up testing of this therapy?
Absolutely, especially since there might be no big dollars in it for
the drug companines.
>Or should such
>research await some sort of more-private funding?
That would be fine, too.
> I have no problem,
>personally, with my tax dollar or NPF dollar going towards further
>further exploration of omega-3s in any form, as long as the research
>is being done as bst it can be done. Double-blind, randomized, and
>controlled. If it were up to me, I'd use inert dyes to make an IV
>bag of saline look like a bag of omega-3s, rather than using the unproven
>"placebo" of omega-6s. I don't think they've been shown to be an
>uneffective treatment.
I do not know enough about the appearance, makeup, or metabolism of IV
EFAs to have any opinion on the specifics, but of course I endorse the
idea that it should be top-quality research. Which is not to say that
some open-label validations of the basic effect might not still be
needed, just to get this thing launched.
>>Lots of bad science in all fields, that's why the process is as it is.
>>Sturgeon's Law: 80% of everything is s*it.
>
>Yeah, but Gary consistently claims that if it winds up published in a
>"peer-reviewed" journal, it must be the "truth".
They usually print results going in every direction, until the
experimental protocols are worked out, the underlying theory is
understood, ... and even then. Let's all keep that in mind, then.
>In this case, the reviewers probably said, "well, omega-6s are
>probably okay as a placebo - don't see any reason why they're
>not." And as long as the rest of the *full* paper (don't forget that Gary
>hasn't read the full text of any article he's cited) doesn't make any
>gross contradictions with those assumptions, it'll pass muster and
>be published.
Maybe it is OK as a placebo, again, I don't know enough about normal
circulating levels of different, specific omegas. A few lines
describing that for us lay readers would have been nice -- hey,
probably plenty of researchers won't know it offhand either.
>>Many days, I'd happily settle for just a little bit of wonderful. A
>>little cautious interest shouldn't hurt in such cases. That's all
>>we're saying.
>
>That's the main thing, J.: that's all I'm saying, too. Gary's interest
>is *far* from "cautious," ...
Well then, maybe that's him. But it's still one thing for you to post
the disclaimers you feel that he doesn't know or doesn't include, and
quite another for you to do an equal-but-opposite unreasonableness,
.. and yet another when you start replying unreasonably to my posts,
eh?
J.
DaveW
>>J., given Gary's (Evetsm) penchant for conspiracy theories, I
>>answered his post in kind.
>
>You perceive him as being unreasonable, so you responded in kind,
>unreasonably?
Actually, that was a problem in editing. Should have been "with that
in mind" instead of "in kind." In real life, I constantly mix the two up,
only to correct myself later on. My hypothesis is that the rhyming has
something to do with my mental screw-ups. I missed this one in the
editing process.
>So, it would be better if I ignored any post where you
>respond to him? Sorry, I didn't realize that was the game.
And you, as a long-time regular here, should have figured it out long
ago, actually. Should I spend the time and bandwidth to do a re-cap
of my "discussions" with Gary over the past two years in every post
so everyone knows the background and personalities involved?
>The question here was specifically about IV EFAs. The question is
>exactly whether all the non-IV EFA studies are relevant or not, the
>suggestion being that they are not.
What?!?!? How did we get from Gary's claim that they are "buried"
to a question of relevancy? Of *course* they're *relevant*, and I have
not seen a single person here suggest that they aren't. Hell, if they'd
been actively buried, that'd make them even *more* relevant (consider
it from the conspiracy point-of-view: if they've been buried, it means
that the entire medical establishment is running scared - the studies
would be not only relevant, but vitally important to us all!).
>>>Steroids have known drawbacks.
>>
>>Every therapy that's well-studied has drawbacks of some sort.
>
>Then it is not reasonable to say, "we have steroids and don't need to
>do research on anything else".
*Please* ignore my posts if you're going to mangle my meaning, J.
I really hate to say that, because I have a lot of respect for you, but
this is an ancient straw man I've been subjected to many times. I never
said the above. Never even implied it.
Here: given the limited resources available, researchers are required to
focus their efforts on new therapies which show a decent amount of
promise. IV EFAs do not, in my opinion, show enough of a hope for
*most* psoriatics to spend those limited funds on more studies *right
now* unless a large, concerted effort is made either by scientists more
"in the know" than we are, or by us. I can just about guarantee that
beyond a few posts here in this newsgroup, Gary has made no such
effort for this particular therapy, so anything he says that even smells
like "suppression" is patently absurd, because he's obviously expecting
others to have already made the effort he *thinks* they should have. Is
that more clear?
>Maybe following the amevive study, the control/placebo group is
>allowed other therapies.
I don't understand what you're saying here.
>This is unreasonable. We know the variability of treatment
>effectiveness for p sufferers, and what little we do know of EFA
>effects. At the least, a confirming study would be relatively cheap
>and easy. At the best, it might look for some way to predict which
>people would benefit from the treatment. That's the future of drug
>therapies, matching the therapy to individual genomes.
Try it again, J.: 'This doesn't appear (to me) to be effective *enough*
to "make up" for any increase in safety.' My statement is based on
my readings of the abstracts and my understandings of other psoriasis
therapies and the new ones being examined. 37% is crap, J. The
folks who are responsible for PVAC took a tremendous hit for coming
in at or below 50% in the latest study, if I remember correctly.
Unreasonable? The idea that good studies done on human beings are
"cheap" is, generally, unreasonable. The idea of being able to match a
treatment to a patient based on genetics is, yes, the *future*, J. It's
unreasonable to expect it anytime soon. The only times it's happened
so far, as far as I know, is when the disease is caused (100% of the
time) by a particular genetic 'flaw'. And even then, patients die in the
testing.
>Again, coal tar is so good, we shouldn't look for anything else? How
>many people does coal tar clear? How many does it not? For those who
>don't clear with just coal tar, or coal tar combined with everything
>else known, we need a broader spectrum of treatments. Or are you
>being purposely unreasonable with me?
You said,
OTOH, "established therapies" have plenty of horrible side-effects
already, so the bar is pretty high there.
To which I challenged, name one "horrible" side effect of coal tar that's
well-documented and of sufficently high probability to eliminate any
doubt that it exists. You failed to respond in any meaningful way to that
challenge. You repeated your earlier straw man attack, then asked two
questions irrelevant to the real point, repeated the straw man *again*,
and then made a back-handed ad hominem attack. Try it again, please.
>>There are some "established therapies" which don't have "horrible" side
>>effects.
>
>Sure, pyramid hats.
Pure and utter baloney, J. I think I've been pretty clear that pyramid hats,
in whatever form they take, should be destroyed as quickly as possible.
They are devastating in their effects, and should be wiped off the face of
the planet. I have little but disgust when pyramid hats are trotted out as
useful therapies. EFAs are not a pyramid hat, and neither are any
*established* therapies for psoriasis (by definition).
>Does it scare you that it might turn out to be valid?
Of course not. Why should it? Do you think I'm in on the conspiracy
to suppress EFAs?
>Well, looking back up at the thread title, let me remind you it's not
>just 3's, and it's not topical use of EFAs, and it's not the ingestion
>of EFAs, and the ineffectiveness of one EFA may not tell us anything
>about another EFA.
Who gives a hoot about the thread title? My post was prompted by
Gary's apparent paranoia, *not* out of some desire to show that IV
EFAs don't work, and/or can't work.
>And, I am very much afraid that your posts do seem
>to say that there is nothing here worth using or studying.
Since you haven't read the above yet, I'll ignore this for now. If you
still feel this way after this post of mine, I'll go dig up my old posts
to refresh your memory on my stated opinions.
>As far as the average practicing derm in the U.S., they might just as
>well be suppressed.
Ah, okay, blame the practicing derms now, who get demands from their
patients to be "fixed." Given the crappy 37% success rate, it seems
reasonable to me for the derms to ignore it. Given the paucity of studies
confirming that 37%, it seems reasonable to me for derms to ignore it.
Given the lack of FDA approval of the therapy, it seems reasonable to
me for derms to ignore it.
>Again, I must say that my experience with EPO is so clear and
>dramatic, in its limited way, that it is SHOCKING to me that it is not
>a standard part of conventional medicine's equipment for treating this
>disease.
Ah, okay. I see now. You've fallen into the "this is *fantastic*, why isn't
anyone else doing it" trap. Since I've spent a lot of time on this
newsgroup pointing out the fallacy here, I'm surprised you fell for it.
>Maybe it only works at all for X%, but for that X% it is dynamite.
Maybe that X% for whom it is "dynamite" only includes you, J.
>As I said above, the customization of treatments to individual patients
>is the trend in high-tech medicine.
Where? Where is it a trend? I've mostly heard of it applied to patients
seeking alternative medicines, homeopathy in particular. I'll readily
acknowledge that it is a goal that mainstream medicine should have,
but right now the only examples I can think of are either hit-or-miss
attempts (first one drug, then another, then another, etc., which is
the standard procedure for psoriasis *right now*), or genetic diseases
which are fully quantified (CF, for example).
>It's supposed to be the rationale for trained doctors being required to
>prescribe treatments. That is, even traditionally, one-size-fits-all is not a
>requirement for treatments.
Hmmm. Go get a urinary tract infection of unknown origin, and see if the
first thing your doctor prescribes *isn't* tetracycline or another broad-
spectrum antibiotic (unless you know you're allergic - is that enough to
be a "customization"?). Go get the flu, and see if the first thing your
doctor offers isn't bed rest and fever reducers. Are you claiming that the
standard of practice in these and many others situations has changed so
that some sort of test is done first to see what the best method of
treatment is? Better yet, name some examples where your apparent
view of reality holds sway in mainstream medicine.
>I do not see these sorts of considerations fairly represented in your
>recent posts on this topic.
As should be obvious by know, it's because I don't think the level of
knowledge about psoriasis is of such a detailed level that it's possible
to do the customization you suggest at diagnosis. Treatment is trial-
and-error, based largely on the type and severity of your disease (for
example, few derms will suggest topical steroids to someone who
presents with full-body psoriasis). Is *that* what you mean by
"customization"?
>Absolutely, especially since there might be no big dollars in it for
>the drug companines.
I think you can take it as a given that there won't be any money in EFAs
for the drug companies. Unless, of course, someone comes up with a
patentable EFA (don't hold your breath).
>I do not know enough about the appearance, makeup, or metabolism of IV
>EFAs to have any opinion on the specifics, but of course I endorse the
>idea that it should be top-quality research. Which is not to say that
>some open-label validations of the basic effect might not still be
>needed, just to get this thing launched.
The open-label research has been *done*. You cited it. What's needed
now is tightly-controlled trials to verify that the effect does indeed exist,
and it's not bias on the part of the researchers that led to the differences
between test and control patients. Hell, J., using saline as a control
just makes the test *better*. I can't find any evidence whatsoever that
omega-6 EFAs *aren't* effective in general, and so their use as a control
is questionable. You've gotta test the substance in question against
something that *known* to be ineffective. I don't think that's ever been
done with EFAs in a double-blinded environment. If they still show a 37%
success rate, while the control group has *less* success than in the
tests already done, that would make the effect *more* pronounced.
>>Yeah, but Gary consistently claims that if it winds up published in a
>>"peer-reviewed" journal, it must be the "truth".
>
>They usually print results going in every direction, until the
>experimental protocols are worked out, the underlying theory is
>understood, ... and even then. Let's all keep that in mind, then.
Actually, it's fairly well known that negative results are published less
often than positive ones.
But something else comes to mind, since in the last week I've been
reading another Shermer book which brought it up. The average
subscription base for scientific journals is about 4,000. Yes, just
4,000 people. I can't say right now whether or not the journal(s) in
which the IV EFA trials were published had readerships of more or
less than that number. But given the odds, I'll admit I was probably
incorrect in saying that the results are widely known. From now on,
*I* will keep that number in mind.
>Maybe it is OK as a placebo, again, I don't know enough about normal
>circulating levels of different, specific omegas. A few lines
>describing that for us lay readers would have been nice -- hey,
>probably plenty of researchers won't know it offhand either.
See above. "Maybe it's okay as a placebo" is a *big* problem. Good
studies only work with things *known* to be either ineffective, or
effective for a certain perentage of people. These are unanswered
questions in relation to omega-6 EFAs.
>Well then, maybe that's him. But it's still one thing for you to post
>the disclaimers you feel that he doesn't know or doesn't include, and
>quite another for you to do an equal-but-opposite unreasonableness,
I didn't think I did, but I'll agree that the words I used at the start of my
last post in this thread wouldn't point one to that conclusion.
>.. and yet another when you start replying unreasonably to my posts,
>eh?
And yet another when you reply with the same old straw men and
other fallacies that Gary trots out on a regular basis, I'm sorry to say.
Finger-pointing is a pretty ugly business, no?
evetsm
>Yeah, but Gary consistently claims that if it winds up published in a
>"peer-reviewed" journal, it must be the "truth".
It is axiomatic unless disproved by a subsequent peer reviewed paper,
not by you. It has to be, since the only alternative is anecdotal and
would you rather I used that (I do in any case for the purpose of
conjecture and dicussion, nothing more) ? Or, would you rather that we
used nothing and withdrew in futile resignation ? The best method,
under imperfect circumstances, is *cross-referenced* peer reviewed
arguments. ie statistically, the more reviewed data that corroborates
a point, the more likely that point is valid and also, the more points
*from different perspectives* that yield the same conclusion, the more
likely the validity of the conclusion. Assuming the conclusion is
rational. That is what I attempted to do here by attacking a premise
from 4 different directions to yield the same conclusion :
http://www.geocities.com/evetsm.rm/psoriasis_and_syndrome_x.html
As to conspiracy, your vast online thesis on why there is unlikely to
be any industrial collusion is disproved by one glaring, huge,
example that pops to mind: the worldwide rigging of vitamin prices.
(The music industry collusion is another that comes to mind.)
If you cannot see *any* conspiracy, that probably means that you are
naive, and not that collusion, rigging, buyoffs, payouts, subterfuge,
extortion and other crime is non-existant among our pristine
conglomerates. It is no conspiracy if it is shown to be true and
vice-versa.
JRStern
>>So, it would be better if I ignored any post where you
>>respond to him? Sorry, I didn't realize that was the game.
>
>And you, as a long-time regular here, should have figured it out long
>ago, actually.
I've long ignored most such threads, but you lay enough of that stuff
out, in threads that I start no less, now and then I'm liable to trip
over it.
>Here: given the limited resources available, researchers are required to
>focus their efforts on new therapies which show a decent amount of
>promise. IV EFAs do not, in my opinion, show enough of a hope for
>*most* psoriatics to spend those limited funds on more studies *right
>now* unless a large, concerted effort is made either by scientists more
>"in the know" than we are, or by us.
This is a bit of pontificating by you, there is not enough evidence to
say yea or nay, and I was not aware that your whim was decisive on
where funds are spent. If you're going to blow your stack when people
disagree on such matters, you are being unreasonable.
>>Maybe following the amevive study, the control/placebo group is
>>allowed other therapies.
>
>I don't understand what you're saying here.
Apparently, in the Amevive study the control group continued to use a
bunch of different treatments. Some cleared during the study. Maybe
that was done in the IV EFA study as well. It certainly clouds any
results. Of course, we expect the control group to show close to zero
clearing. Anything else is anomalous.
>Try it again, J.: 'This doesn't appear (to me) to be effective *enough*
>to "make up" for any increase in safety.' My statement is based on
>my readings of the abstracts and my understandings of other psoriasis
>therapies and the new ones being examined. 37% is crap, J.
Not if you're one of the 37%. You can't make these calls on a single
number. If it could be shown that 1% were cleared by chanting, and
nobody hurt by it, it would be a valuable asset to the arsenal. Would
you be against the prescription of something like that on a trial
basis, just because it was EXPECTED to fail 99% of the time?
Sure, 37% is low, but why is it not zero? More studies might be
helpful.
>The
>folks who are responsible for PVAC took a tremendous hit for coming
>in at or below 50% in the latest study, if I remember correctly.
I never saw the full write-up on that. The FDA likes to hear 75%,
apparently, but (see threads on Amevive) I hope they don't get hung up
on one or two summary figures of merit to the exclusion of some
unipolar benefits that might be had.
>Unreasonable? The idea that good studies done on human beings are
>"cheap" is, generally, unreasonable.
People with light psoriasis are plentiful, the treatment does not
involve anything high-tech. As things go these days, this one sounds
very cheap indeed, though of course it is all relative. Few hundred
grand would likely be required, is my guess, but that's not the
half-billion they say a new ethical drug costs including research.
> The idea of being able to match a
>treatment to a patient based on genetics is, yes, the *future*, J. It's
>unreasonable to expect it anytime soon.
Crap. There was a M*A*S*H episode on the other night, about how some
malaria (?) treatment turned out to be dangerous for those of certain
ethnic groups back in 195x. Seems to me there are others known along
those lines already, and if not, they're coming fast. We'll all be
carrying around our genome on little smartcards (or at least a URL to
the data, I suppose) before this decade is out. You heard it here
first.
>>Well, looking back up at the thread title, let me remind you it's not
>>just 3's, and it's not topical use of EFAs, and it's not the ingestion
>>of EFAs, and the ineffectiveness of one EFA may not tell us anything
>>about another EFA.
>
>Who gives a hoot about the thread title?
I dunno, let's get the NSF to fund a study.
(This is appropriate sarcasm, btw, and if you want it explained
further, just take a deep breath and hold it until you understand)
>>As far as the average practicing derm in the U.S., they might just as
>>well be suppressed.
>
>Ah, okay, blame the practicing derms now, who get demands from their
>patients to be "fixed." Given the crappy 37% success rate, it seems
>reasonable to me for the derms to ignore it. Given the paucity of studies
>confirming that 37%, it seems reasonable to me for derms to ignore it.
>Given the lack of FDA approval of the therapy, it seems reasonable to
>me for derms to ignore it.
If it ain't in the drug company catalog, the way medicine is
practiced, of course derms wouldn't likely attempt it. But, wouldn't
it be swell if they were at least better informed. A little
discussion, and a few recalcitrant cases might find a place where some
research could be performed, etc.
>>Again, I must say that my experience with EPO is so clear and
>>dramatic, in its limited way, that it is SHOCKING to me that it is not
>>a standard part of conventional medicine's equipment for treating this
>>disease.
>
>Ah, okay. I see now. You've fallen into the "this is *fantastic*, why isn't
>anyone else doing it" trap. Since I've spent a lot of time on this
>newsgroup pointing out the fallacy here, I'm surprised you fell for it.
Don't get yourself stuck in a rut, I didn't say that. This is again
the topic of what's best done with some treatments that may be very
effective but for a small number of people.
>>Maybe it only works at all for X%, but for that X% it is dynamite.
>
>Maybe that X% for whom it is "dynamite" only includes you, J.
Chill, Dave. You should know that traffic on this group says
otherwise, and the long mention of EFAs in the nutritional literature
says there just may be something out there that's worth noticing.
>>As I said above, the customization of treatments to individual patients
>>is the trend in high-tech medicine.
>
>Where? Where is it a trend?
Bunch of biotech startups, making diagnostic chips along those lines.
I concede this may not be well known, but you should find it in
searches of either biotech of financial lit on the industry. There've
been articles in major news magazines and newspapers. Like that.
>>It's supposed to be the rationale for trained doctors being required to
>>prescribe treatments. That is, even traditionally, one-size-fits-all is not a
>>requirement for treatments.
>
>Hmmm. Go get a urinary tract infection of unknown origin, and see if the
>first thing your doctor prescribes *isn't* tetracycline or another broad-
>spectrum antibiotic (unless you know you're allergic - is that enough to
>be a "customization"?).
Sure, known allergies can be a start in that direction. Anyway, even
tho medicine today suggests these blanket first-attempts, when those
fail, that's when you get customization. That's why you have
treatment trees in psoriasis. That's why you get Remicade along with
blood tests -- doctors *know* it's going to blow out on some number of
patients and have to be there to pick up the pieces. If it was
one-size-fits-all, there'd be much less care needed (arguably none).
It's common. It's universal.
>>I do not know enough about the appearance, makeup, or metabolism of IV
>>EFAs to have any opinion on the specifics, but of course I endorse the
>>idea that it should be top-quality research. Which is not to say that
>>some open-label validations of the basic effect might not still be
>>needed, just to get this thing launched.
>
>The open-label research has been *done*. You cited it.
Hey Mr. Peer-Review-Ain't-Gospel, one study ain't enough. We don't
all jump to conclusions as easily as you.
> What's needed
>now is tightly-controlled trials to verify that the effect does indeed exist,
>and it's not bias on the part of the researchers that led to the differences
>between test and control patients.
Thank you for agreeing. Have a talk with yourself sometimes, you can
be pretty reasonable when the mood takes you.
>But something else comes to mind, since in the last week I've been
>reading another Shermer book which brought it up. The average
>subscription base for scientific journals is about 4,000. Yes, just
>4,000 people.
And how many people read them all? Or remember?
> But given the odds, I'll admit I was probably
>incorrect in saying that the results are widely known. From now on,
>*I* will keep that number in mind.
It is easy to slip into the mistake of believing that if one person
knows a fact, everyone does.
>>Maybe it is OK as a placebo, again, I don't know enough about normal
>>circulating levels of different, specific omegas. A few lines
>>describing that for us lay readers would have been nice -- hey,
>>probably plenty of researchers won't know it offhand either.
>
>See above. "Maybe it's okay as a placebo" is a *big* problem. Good
>studies only work with things *known* to be either ineffective, or
>effective for a certain perentage of people. These are unanswered
>questions in relation to omega-6 EFAs.
So, let's not bloviate about it, let's get some more research.
J.
DaveW
>This is a bit of pontificating by you, there is not enough evidence to
>say yea or nay, and I was not aware that your whim was decisive on
>where funds are spent. If you're going to blow your stack when people
>disagree on such matters, you are being unreasonable.
Wanna see me blow my stack, J.?
Pontificating? You unbearable hypocrite. I was offering my damned
opinion. Just like you do all the freaking time. I even said, "in my
opinion," in order to *show* that it's just an opinion. I'll quit
"pontificating"
when you do, you holier-than-thou ass. What the hell is up your butt,
anyway? I've never seen you stoop to insults like the above...
>(This is appropriate sarcasm, btw, and if you want it explained
>further, just take a deep breath and hold it until you understand)
...or this...
> We don't all jump to conclusions as easily as you.
...or this...
>Thank you for agreeing. Have a talk with yourself sometimes, you can
>be pretty reasonable when the mood takes you.
...or this...
>So, let's not bloviate about it, let's get some more research.
...or this.
I must say the high respect I once held for you, J., is now completely
gone. Dammit, this sucks.
>I've long ignored most such threads, but you lay enough of that stuff
>out, in threads that I start no less, now and then I'm liable to trip
>over it.
Well, ignorance was apparently bliss. You're welcome to it. Have
fun.
>... If you're going to blow your stack when people
>disagree on such matters, you are being unreasonable.
My stack was blown not because "people disagreed," but because one
particular person was being unreasonable (and still is), while calling *me*
unreasonable. Hypocrisy gets to me, J., but you've probably been
blissfully unaware of that fact.
>Apparently, in the Amevive study the control group continued to use a
>bunch of different treatments. Some cleared during the study. Maybe
>that was done in the IV EFA study as well. It certainly clouds any
>results. Of course, we expect the control group to show close to zero
>clearing. Anything else is anomalous.
No, nobody who knows anything about clinical testing would ever
expect "close to zero clearing." That's an unreasonable assumption.
Read up on it, J.
>Not if you're one of the 37%.
Yeah, which is why testimonials are so effective at selling products.
>You can't make these calls on a single
>number. If it could be shown that 1% were cleared by chanting, and
>nobody hurt by it, it would be a valuable asset to the arsenal. Would
>you be against the prescription of something like that on a trial
>basis, just because it was EXPECTED to fail 99% of the time?
Yes and no, it depends on the circumstances. If a pilot study showed
such an abyssmal number, and that 1% demanded a piece of my tax
money go towards further study, I'd tell 'em where to stick it. On the
other hand, if the 1% number were already shown to be *the* figure,
then it's up to an individual to try it or not, as long as they're *fully
informed*. If someone showed up here asking about that great chanting
therapy they'd heard about, I'd feel obligated to inform them that "great"
only means 1% success. If they still want to try, that's up to them.
My main point here, J., is that taking time and money away from the
studies being done on therapies that are more inside the bell curve of
responses is, IN MY OPINION, bad public policy. If you're on the
edge of the curve, I feel sorry for you, but "the good of the many" and
all that...
>Sure, 37% is low, but why is it not zero?
Because it's human medicine, J. The nature of the beast is that some
therapy will 'cure' some people, no matter what. Read up on placebos
and clinical trials. *Nobody* expects zero, or even close to zero. If
the expected rate were always near zero, the control group could be
done away with, and testing would become much cheaper.
>More studies might be helpful.
Yes, to further quantify that 37% value, but not to try to find out why it's
not zero.
>People with light psoriasis are plentiful, the treatment does not
>involve anything high-tech. As things go these days, this one sounds
>very cheap indeed, though of course it is all relative. Few hundred
>grand would likely be required, is my guess, but that's not the
>half-billion they say a new ethical drug costs including research.
Again, to do studies with the intent of bringing IV EFAs into the realm
of working therapy, no matter how high or low the rate of success
would require an NID application which would run several million bucks
all by itself. The design and manufacture of a good placebo would
probably cost many thousands, once you figure in all the overhead.
Then there's salaries for the doctors, nurses, accountants, record-
keepers, statisticians, etc., etc..
>Crap. There was a M*A*S*H episode on the other night, about how some
>malaria (?) treatment turned out to be dangerous for those of certain
>ethnic groups back in 195x.
Hmmm. Yeah, we all know that M*A*S*H is a good reference.
>Seems to me there are others known along
>those lines already, and if not, they're coming fast. We'll all be
>carrying around our genome on little smartcards (or at least a URL to
>the data, I suppose) before this decade is out. You heard it here
>first.
Fine it's *largely* the future, and some of it - if we're to believe M*A*S*H
and your "seems to me" - is here now. And I heard it here first. But
basing your current arguments on TV shows and future possibilities is
nothing more than living in delusion. It cannot be done for psoriasis
right now, so making a point as if it were is simply ludicrous.
>If it ain't in the drug company catalog, the way medicine is
>practiced, of course derms wouldn't likely attempt it. But, wouldn't
>it be swell if they were at least better informed. A little
>discussion, and a few recalcitrant cases might find a place where some
>research could be performed, etc.
Yes, it would be swell, but this "wouldn't it be great if" scenario you've
outlined here is a far cry from Gary's conspiracy theories.
>>Ah, okay. I see now. You've fallen into the "this is *fantastic*, why
>isn't anyone else doing it" trap. Since I've spent a lot of time on this
>>newsgroup pointing out the fallacy here, I'm surprised you fell for it.
>
>Don't get yourself stuck in a rut, I didn't say that.
No, you didn't. You said:
Again, I must say that my experience with EPO is so clear
and dramatic, in its limited way,
(I read, "this is fantastic" - in its limited way)
that it is SHOCKING to me that it is not a standard part of
conventional medicine's equipment for treating this disease.
(I read, "why isn't anyone else doing it?")
>This is again the topic of what's best done with some treatments
>that may be very effective but for a small number of people.
And I'll say it again: find someone to do more testing. Don't fall into
Gary's illogic of seeing a possible treatment sitting idle, so you
point your finger and shout "it's been buried!" That was my main
point in writing that first post in this thread. The secondary point
was that Gary's "results like these" comment strongly implied that
the results were almost miraculous, while the reailty is far from it.
You appear to have read still other things into that post of mine.
>Chill, Dave.
Cram it, J. This "I'm fine but you're out of control" picture you're
attempting to paint of yourself and me is shown to be a lie by
the insults, "appropriate" and otherwise, that you spewed in this
post.
>You should know that traffic on this group says
>otherwise, and the long mention of EFAs in the nutritional literature
>says there just may be something out there that's worth noticing.
No, I was specifically talking about your experiences with EPO,
which is what the "X%" comments directly followed. I've already
addressed the rest, several times. What if the X% is *only* those
few who've reported good results on this newsgroup? Is an 0.001%
success rate good enough? Where does the line get drawn?
>Bunch of biotech startups, making diagnostic chips along those lines.
>I concede this may not be well known, but you should find it in
>searches of either biotech of financial lit on the industry. There've
>been articles in major news magazines and newspapers. Like that.
Are any of these things actually on the market? For what diseases
and genetic conditions to they cross-reference and suggest varying
courses of treatment?
>Sure, known allergies can be a start in that direction. Anyway, even
>tho medicine today suggests these blanket first-attempts, when those
>fail, that's when you get customization. That's why you have
>treatment trees in psoriasis. That's why you get Remicade along with
>blood tests -- doctors *know* it's going to blow out on some number of
>patients and have to be there to pick up the pieces. If it was
>one-size-fits-all, there'd be much less care needed (arguably none).
>It's common. It's universal.
Right, but you're comments about customization implied that it was
regularly being done, nowadays, at time of diagnosis. In other words,
what I read was "oh, if you're of thus-and-such a genotype, then you'll
get thus-and-such a drug if you come down with these symptoms."
The blood tests on Remicade are *not* customized - *everyone* gets
them, because nobody knows *who* will "blow out" *before* it
happens. Just like the liver-function tests while on MTX. Or serum
calcium testing if you're on high doses of Dovonex.
>>The open-label research has been *done*. You cited it.
>
>Hey Mr. Peer-Review-Ain't-Gospel, one study ain't enough.
There are at least two, J. And one *open-label* study *is* enough to
warrant further research, with better controls, in many cases. Why
should more open-label studies be done? Just to see the numbers
fly all over the map, and add *more* confusion to the issue?
>We don't all jump to conclusions as easily as you.
It is beyond my comprehension why you've chosen to mimic Gary
in so many ways. My "conclusion" is and always has been, "yes,
more study would be nice, but not on my nickel." See, we don't all
misrepresent other people's opinions as easily as you.
(You've also picked up Gary's habit of only responding to half, or
less, of the points I make. Are you picking-and-chosing *just* to
be insulting and argumentative, as it appears?)
>It is easy to slip into the mistake of believing that if one person
>knows a fact, everyone does.
And here we see how easy it is to turn what should have been seen
as an apology into an opportunity for some condescending words.
Oh, *thank* you, J., for showing me the error of my ways. (This is
appropriate sarcasm, etc., etc.)
>So, let's not bloviate about it, let's get some more research.
Go for it. I don't have the time, the funds, the motivation, the fund-
raising experience, or the "granting" ability to do so correctly.
DaveW
> It is axiomatic unless disproved by a subsequent peer reviewed paper,
> not by you.
This just goes to show how little you know about the way science
works, Gary. One, two, or a handful of studies show some effect.
This can only be taken as very tentative evidence that said effect
actually exists. It is *never* license to call that effect axiomatic.
Perhaps you're using a different definition of the word: an axiom
is something which is either self-evident, or something that's assumed
to be true without proof. The reason studies are done, and then
published in peer-reviewed journals, is because the things they
test are *not* axiomatic. No study, or any number of studies, can, in
any scientific sense, *prove* that any effect is real. To use pilot
studies with small samplings of patients as axioms is begging for your
entire train of logic to be derailed quite easily.
> It has to be, since the only alternative is anecdotal. . .
That's simply a false dichotomy. There are many alternatives
available, you've just got your blinders on. How about this:
let's treat scientific papers as they're supposed to be treated.
Not as axioms (one small study is positive - must be the truth!).
Not as anecdotes (one small study is positive - must be completely
worthless!). There is a middle ground which you routinely ignore.
> The best method, under imperfect circumstances, is *cross-
> referenced* peer reviewed arguments.
Right. And you've ignored your own peer review from the start,
four-plus years ago. Namely Ed, myself, and others who've shown
you where your errors are.
> ie statistically, the more reviewed data that corroborates
> a point, the more likely that point is valid and also, the more
> points *from different perspectives* that yield the same conclusion,
> the more likely the validity of the conclusion. Assuming the
> conclusion is rational.
You also need to assume the viewpoints are both valid and true. If
they're not, then a "rational" conclusion based on those viewpoints
is utterly worthless. For example, if I take it as an axiom that the
sky is a crystal sphere, then it's easy to reach the "rational"
conclusion that the sky is blue because of paint. It's a completely
rational conclusion to come to when your starting point is invalid.
Also, bias in interpreting study abstracts must be considered. If
you believe, for example, that the sky is a crystal sphere, then
any time "confirming" evidence comes along, like that a study showed
that the sky *might* be blue because of paint, you'll turn that
"might" into a "probably" or a "certainly" due to your already-held
beliefs. But that kind of "logic" quickly turns circular.
> That is what I attempted to do here by attacking a premise
> from 4 different directions to yield the same conclusion :
>
> http://www.geocities.com/evetsm.rm/psoriasis_and_syndrome_x.html
Since I don't believe you've read
http://members.aol.com/psorsite/docs/evetsm.html
allow me to summarize the problems with your four lines of attack:
1) You use only half the definition of Syndrome X. Reaven shows
cause-and-effect relationships, which you ignore. Under your defintion,
it would appear that smoking is a disease of Syndrome X.
2) The word "postulate" means "to assume without proof." Therefore,
you are asking that we believe that TZDs are good tools for discovering
IR diseases on nothing but faith. This is the worst kind of starting
point for an argument.
3) Disease correlation cannot show cause and effect.
4) You're assuming that the only cause of high-birth-weight babies is
a thrifty genotype, which is not confirmed by the studies you present.
> As to conspiracy, your vast online thesis on why there is unlikely to
> be any industrial collusion is disproved by one glaring, huge,
> example that pops to mind: the worldwide rigging of vitamin prices.
> (The music industry collusion is another that comes to mind.)
I dealt with this sloppy "disproof" when you first brought it up.
Why is it that I have to repeat myself? Your objection is nothing
but a straw man, because it is *not* my opinion that there is *no*
collusion whatsoever. My "thesis" attempts to disprove the idea
that there's no money in finding a patentable cure for psoriasis,
*not* that conspiracies never exist.
What was your response? Three companies were caught fixing prices
on vitamins in Euope. Or that five record companies fixed prices
on CDs. So what? It was never my intent to prove that companies
never ever conspire to defraud the public. The fact that these
companies were *caught* proves one tiny point made in my thesis
very well, since it shows just how tough it is to conspire secretly
to do anything.
> If you cannot see *any* conspiracy, that probably means that you are
> naive, and not that collusion, rigging, buyoffs, payouts, subterfuge,
> extortion and other crime is non-existant among our pristine
> conglomerates.
If I actually held the view that none of those things happens, I
would be naive, yes. Luckily, I don't hold this view, which you have
attributed to me on more than one occassion. It's just another
classic straw-man attack, and is completely invalid. Gary, argue
against the points I actually make, not those you invent for me.
> It is no conspiracy if it is shown to be true and vice-versa.
What? The word conspiracy is only applicable if there is no
conspiracy? Are you making up definitions again? Why is it that
criminals are routinely convicted of conspiracies?
evetsm
> Gary wrote:
> > It is axiomatic unless disproved by a subsequent peer reviewed paper,
> > not by you.
>
> This just goes to show how little you know about the way science
> works, Gary. One, two, or a handful of studies show some effect.
> This can only be taken as very tentative evidence that said effect
> actually exists. It is *never* license to call that effect axiomatic.
> Perhaps you're using a different definition of the word: an axiom
> is something which is either self-evident, or something that's assumed
> to be true without proof. The reason studies are done, and then
> published in peer-reviewed journals, is because the things they
> test are *not* axiomatic.
The results of peer reviewed studies are axiomatic ie. generally
accepted, until proved otherwise. Otherwise, why bother ? Why on earth
should an untested premise, or "the things they test", be axiomatic ?
Who is suggesting that and why even bring it up ? You don't know what
you are talking about. As usual.
>It is *never* license to call that effect axiomatic
Rubbish. Euclidean geometry was axiomatic until space-time and so was
Newton until relativity.
Enough already with the Green Ham and Eggs !
DaveW
> The results of peer reviewed studies are axiomatic
> ie. generally accepted, until proved otherwise.
That's why I posted the definition of the word "axiom."
You apparently don't know what it means, yet you keep
using it.
The results of peer-reviewed studies are *regularly*
disputed on the methodology of the study, the controls
used, the source, and numerous other features. The
least-controlled studies, the small pilot studies are
not "generally accepted" as anything other than as
"baby steps" towards building a larger body of evidence.
They are medical "trivia" until either refuted or
supported.
> Otherwise, why bother ?
Because it's a *test*, Gary. If a pilot study comes
out negative, then you say, "well, my theory was false,"
and move on to something else. If it comes out positive,
you say, "hey, I *might* be onto somthing, I need to do
more testing and *publish my results so that others can
tell me what I'm doing wrong*." That's what peer review
and publishing are all about. Peer-review is *not* the
ultimate judge of a study's worth. After it gets reviewed,
subscribers to journals read the articles, and sometimes
say, "what the heck were those reviewers thinking? This
is garbage!" Once again, reviewers are not Gods, and
cannot decide whether or not a study is reporting the truth
(especially studies on things which have never been tested
before, as should be self-evident).
> Why on earth should an untested premise, or "the
> things they test", be axiomatic ?
Because it's part of the definition of the word axiom?
"Accepted without evidence." The other meaning is
"self-evident." If it's self-evident, then no testing
is needed. *That* is axiomatic.
> Who is suggesting that and why even bring it up ? You
> don't know what you are talking about. As usual.
No, as usual you are using scientific terms in your own
unique way. That's called "pseudoscience."
> Rubbish. Euclidean geometry was axiomatic until space-
> time...
Rubbish, yourself. Established geometries of all sorts
are neither self-evident nor without evidence supporting
the rules, theorems, and defintions (axioms) held within
the geometry. And by your definition of "axiomatic,"
you'd have us believe that space-time "disproved"
Pythagoras. Funny, but carpentry still seems to get
along just fine.
> ...and so was Newton until relativity.
More rubbish. Neither Newton or Einstein wrote anything
that could be considered even close to self-evident. And
both's works are well-supported by evidence. And Newton's
work is still alive and well in the everyday world of the
slow (not "disproved"). Or do you think anyone pays any
attention to the fact that a NASCAR Winston Cup car doing
200 MPH is actually about 93 quadrillionths of an inch
shorter than one at rest? Newton wasn't "disproved" by
Einstein, good ol' Al just added a teensy-weensy "touch-up"
in the realm of the everyday, and a big whopping correction
when you go very, very fast (to drop an entire inch off the
car's length, one would have to drive at over 65 million MPH,
or 9.8% of c - and that's hard on the tires).
> Enough already with the Green Ham and Eggs !
Yes, you should stop reading Dr. Suess and pick up a
dictionary.
evetsm
questions and since I stumbled yesterday upon more of the accusatory
dreck that you litter over the internet(in the same vein as the
"companies do not collude" tome), I have answered you in point form at
the end of the piece in some my own internet litter and here is the
conclusion :
"In conclusion, until Davew understands the difference between a
linear, uni-directional, cause and effect and the interchangeable
cause and effects of a positively disturbed feedback control loop, he
will always search in vain for IR as an absolute cause or effect of
diseases of Syndrome X. Understanding the Thrifty-Genotype hypothesis
will help him grasp how this feedback control loop is originally
disturbed and what people are likely to be susceptible. Second, until
Davew stops thinking in absolutes and starts thinking statistically
and probabilistically, and until he graps the implications of the
phrase "statistical significance", he will forever believe that I have
to be either completely wrong or completely correct. "
http://www.geocities.com/evetsm.rm/psoriasis_and_syndrome_x.html
This wait may be in vain, since it has been 4 years and he still has
not cottoned on.