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Harriet Hall CFS: Rituximab Revisited in Science-Based Medicine

funkyqueen

Senior Member
Messages
123
Location
South of France
I must admit, worse than this " paper" itself , (I rarely read anything so bad and non-objective), some of the comments of some PWMEers , made me more angry

... Honestly, it made me more than tired, to note the lack of objectivity of this article/some comments, and as one of these PWMEers who benefit from this Rituximab protocol, some comments below this article (I have not read the 90) just have fractured my retina !!

In short, I will not react on the hoof, and I even think I will not respond at all, except for the comment I already added few hours ago ... Sad ... I do not have other words ...
 

barbc56

Senior Member
Messages
3,657
@Jonathan Edwards

That is indeed Dr. Hall. However disappointed I am with this particular blog, actually a few others of hers as well but don't feel comfortable saying more, she does write some very good ones and that makes it even more disappointing!

The Science Based Medicine blog isn't everyone's cup of tea and that's okay. But I do read it daily, after coming here of couse, as it's part of my morning ritual. Interestingly, considering the phrase I used in the previous sentence, while drinking my morning tea!

I've even thought of writing to the site but I'm not sure if it's worth the energy.

Barb

ETA It may also be self evident to the other contributors of the blog. The incredible James Coyne is also one of the contributors but too infrequently. I love the JC's perspective on the world! He's gutsy and has a lot of integrity. I would love to see him write about PACE on SBM.
 
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funkyqueen

Senior Member
Messages
123
Location
South of France
It`s stated in either the phase 1- or phase 2 study. Can`t remember which :) In the phase 1 paper there is a graph showing the transient worsenings in the responders.

Oh really ? If i do not read properly the phase II bis of Fluge & Mella's studies, i done it with the first one ...but it may be that I have missed it (or my brain is too optimistic and wanted to forgoted it ;) ). Thank you. I'll read it again carefully.

Edit : @Marky90 , are you sure that you do not confuse with the relapse period ?
 

BurnA

Senior Member
Messages
2,087
I must admit, worse than this " paper" itself , (I rarely read anything so bad and non-objective), some of the comments of some PWMEers , made me more angry

... Honestly, it made me more than tired, to note the lack of objectivity of this article/some comments, and as one of these PWMEers who benefit from this Rituximab protocol, some comments below this article (I have not read the 90) just have fractured my retina !!

In short, I will not react on the hoof, and I even think I will not respond at all, except for the comment I already added few hours ago ... Sad ... I do not have other words ...

@funkyqueen i was intrigued so i read some comments ( i dont normally ).
It seems quite a well orchestrated campaign of comments - i dont think there could be any other explanation.
This is my "favourite"
It may have no relevance to your case, but in my case after years of fruitless searching for a "medical" explanation it's pretty clear to me that my fatigue is the result of an anxiety disorder coupled with severe life stress. And believe it or not, the best treatment some days seems to be to jump on the bike no matter how awful I feel. I've been misdiagnosed with many things under the sun.

and this

It seems like it'd be a godsend for people with depression who do not want to have a mental illness.

ok... no more
 
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Marky90

Science breeds knowledge, opinion breeds ignorance
Messages
1,253
Oh really ? If i do not read properly the phase II bis of Fluge & Mella's studies, i done it with the first one ...but it may be that I have missed it (or my brain is too optimistic and wanted to forgoted it ;) ). Thank you. I'll read it again carefully.

Edit : @Marky90 , are you sure that you do not confuse with the relapse period ?

From phase 2 discussion:
"Two patients experienced an allergic reaction to rituximab-infusions. In the majority of patients no infusion-related symptoms or subsequent ME/CFS worsening could be noted. In eight patients, symptom flares were observed after one or more rituximab infusions. This is infrequent in lymphoma patients receiving rituximab. Such transient worsening also occurred when a patient was B-cell depleted and had a sustained major response, and usually lasted for days to a few weeks. However, we have observed one patient included in another study (KTS-3-2010, for patients with severe or very severe ME/CFS) who experienced such transient symptom worsening lasting for almost three months. Based on pilot observations, a slow infusion rate of rituximab seems to reduce this problem, and in the presently ongoing randomized phase III study (“RituxME”) all intravenous infusions are given over approximately four to five hours infusion time. The symptom worsening seems similar to that described after infusion of normal human immunoglobulins as a therapeutic option in adolescent ME/CFS [41] and may indicate an unspecific immunoglobulin effect in these patients."
 

BurnA

Senior Member
Messages
2,087
You can post on the blog without registration. Just saying. Also a reader comment suggested Dr Hall contact you for information about side effects and safety.

I posted, but i feel bad having anything to do with that article.
If the author was interested in learning about this topic or helping patients in any way they would not have written this piece. They have no interest in contacting anybody becasue if they cant do a basic google search to check some facts that says it all.
I think its time to move on and let this piece disappear, but of course we will remember it when the correct time comes :)
 

Snowdrop

Rebel without a biscuit
Messages
2,933
Many patients' lives are bad enough for them to legitimately feel like a risk was worth taking for them; that is their own business and a judgement for them alone.

So what if she has a few legitimate points about using a drug that has the possibility to cause harm.
So bloody what. I am fed up with robustly healthy people getting all high minded on our behalf (she is saying all this for our own protection/benefit/education right?).

If a drug has side effects it should be clearly acknowledged. I couldn't agree more.

But that 'risk' very much changes when you've been languishing for decades and tried all kinds of things that haven't worked.
We need real treatment NOT another oh my, that's sooo risky you shouldn't go there.
What's her stake in all this by 'helping' to inform on this.

It's a bloody risk crossing the street--or eating a strawberry too if you have the misfortune of getting hit or being allergic.
My sense of 'risk' is very different from someone who has absolutely no need for the drug and can wax theoretical on the subject.

Life carries risk. Risk can't be eliminated from the equation. And even when the risk is small (and therefore not very risky at all) if YOU are the one it affects the risk to YOU is 100%. These things are not amenable to the level of certainty her conclusions suggest.

And then there is the issue of motivation. Why the deep concern for our wellbeing on the subject. Indeed one could say THINK OF THE CHILDREN with regards to sectioning and to forced treatments given by the psych's who have no business whatsoever in being involved with treatment of the incredibly debilitating illness. Motivation is a slippery issue--one can be convinced that their motives are indeed pure and that their judgment is sound--believing in their own rationality can just be another word for rationalising one's biases.

While we're all subject to potential for doing that some are more willing to look deeper--other's have too much at stake to look beyond a hairs breadth at the possibility their concern is for protecting something of their own not in exposing some risk to others. Make no mistake how something gets said and why it's being said is important too. That's why we have the phrase 'the pen is mightier than the sword'. If it didn't matter we would not have so much of the literature and stories we enjoy.

This is now just a general comment on the use of words in general as directed at the ME community and all the issues around our illness. We (people in general) tend to look at a study or an article at face value--we may even feel there is no way to go any further in parsing any meaning from something. This is extremely useful to those who wield words like weapons. People's motives matter. How they say things and why those particular things matter. They know that--we need to be just as savvy. It is possible to say things with a view to obfuscate, evade, deflect, dismiss, denigrate, minimise, exaggerate, confuse, deny.

I'm impressed with the few (and I hope growing number of) journalists who have taken the time to examine the issues around this illness and who listen to patients and not dismiss us as stupid or lazy. However I am fed up with all the journalists and political sycophants and really not very good psych researchers around this illness who have their heads so far up their arse that the pitch blackness has them lost to the possibility that they have been co-opted for something less than reasons of pure science.

Some of course know quite clearly what it's all about---despite their strenuous denial of harm.

**This rant took some time for me. So with any luck for all our sakes it's not likely I'll do it again any time soon.** ;)

Also, ust an edit to note that I didn't read all posts before posting myself.
 
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JohnCB

Immoderate
Messages
351
Location
England
Having now seen her other post linked to in the first post in this thread, especially the crap about 'psychological factors' and 'deconditioning', I am strongly in agreement.

Both blogs do seem very superficial. I reminds me of newspaper health columns where the resident doctor makes superficially knowledgeable remarks and seems to be an expert in everything, however when you dig below the surface they have grabbed a report in a journal and selected bits and interspersed some personal opinion. The IoM article was dreadful. The Rituximab article worried me with all the anonymous quoting. I was also miffed by the lack of any link to abstracts of reports. Yes, clearly Rituximab is a horrible drug in the wrong hands, but I already knew that from other responsible reporting. I don't think the blog lives up to its name of Science-Based Medicine
 

Snowdrop

Rebel without a biscuit
Messages
2,933
Yes, clearly Rituximab is a horrible drug in the wrong hands,

And also common sense and falls into the category of general and somewhat obvious knowledge. One can say this about so many things.
Why make a point of it for us poor sods who don't have anything better and thanks so much to the concerns from certain quarters that we only consider their treatment to be sound.
 

halcyon

Senior Member
Messages
2,482
This is tabloid level stuff. Perhaps Dr. Hall should consider a career as a writer for the Daily Mail.

It's in extremely poor taste for her to exploit the openness that Whitney and his family have had with his illness, allowing other patients and the world to see the intimate details of his life with the illness. They share these details so that others may be helped by seeing it, not so some outsider can write a smear piece on one of our clinicians, remotely diagnose him with PML without ever seeing him, and further the view that we are not ill enough to be treated with serious interventions.
 
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adreno

PR activist
Messages
4,841
There seems to be a pattern to the behavior of these "debunkers". After a while (and getting a few followers) they start to believe in their own superiority and think they can have expert opinions on everything by glancing over a few abstracts.
 

Snowdrop

Rebel without a biscuit
Messages
2,933
There seems to be a pattern to the behavior of these "debunkers". After a while (and getting a few followers) they start to believe in their own superiority and think they can have expert opinions on everything by glancing over a few abstracts.

Uhhh, well of course. that's exactly how I became an expert on temporal-spacial mechanics--with a specialty in black hole specific non-linear gravitational anomalies. ;):woot::whistle::alien:
 

barbc56

Senior Member
Messages
3,657
I guess the interesting question is who has she been manipulated by? Maybe some people already know.

Why do we automatically assume someone has influenced her? Did I misread your comment? My take is that she wrote a crappy blog not aimed to disrespect the condition of me/csf or patients but to express concerns about prescribling rituximab off lable. I feel that's a valid point but that may be neither here nor there.

I absolutely found her use of sloppy/ unscientific writing as well as the fact that she exploiting a patient deplorable and unprofessional. It's sloopy rather underhanded but that doesn't necessarily mean she's against us. It's bad writing which is a different issue.

So far I have found the comments from readers very respectful with just a few that aren't, which is a hugh improvment over previous blogs. Even Harriet Hall somewhat redeems herself with one comment, but only somewhat and I will have to come back and post the comment.

My view and can only speak for myself is that some here are so wedded to the hope that rituximab will help people and that view is understandable, is not only coloring views of her but spills over to interpretation of the comments. This defensiveness at least on this board as I haven't yet seen any from patients on the SBM comments yet, is counterproductive and nitpicking as well as being available for anyone to view. Many of the comments by readers on SBM actually seem appropriate, often asking for clarification which in and of itself is not mocking us.

Going in with the bias that she must be against us since she doesn't agree with the stance that Rituximab should be available off label and then accuse her of bias is disingenuous.

This has come back to bite us before. The anger is legitimate. But if we expect to be treated fairly we need to do the same thing.

We have every right to express our dismay and anger. But its also important to keep in mind how we word things. We are adults not kindergarteners fighting on the playground.
 
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