Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
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X-member
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Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by X-member » Sun 14 Jul 2019 21:16

Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

https://clinicaltrials.gov/ct2/show/NCT03891667

A quote:
Brief Summary:

Approximately 10-20% of patients experience ongoing symptoms despite having received standard antibiotic therapy for Lyme disease. Possible explanations for persistent symptoms include persistent infection and/or post-infectious causes. Recent in vitro studies indicate that disulfiram is effective at killing both the actively replicating and the more quiescent persister forms of Borrelia burgdorferi, the microbe that causes Lyme Disease. In this study, the investigators are examining the safety of disulfiram among patients with post-treatment Lyme disease symptoms. The investigators are also conducting a preliminary investigation regarding the relative benefit of 4 vs 8 weeks of treatment with disulfiram.

X-member
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Re: Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by X-member » Sun 14 Jul 2019 23:42

Perhaps the article below also belong in this thread?

Disulfiram–breakthrough drug for Lyme and other tick-borne diseases?

By Daniel A. Kinderlehrer MD

11 JUL 2019

https://www.lymedisease.org/disulfiram-kinderlehrer/

A quote:
A willing patient

But a patient of Dr. Ken Liegner of Pawling, New York, saw the lecture by Dr. Kim Lewis on YouTube and asked to be treated with disulfiram. This patient had been infected in May 2008, and diagnosed with Lyme disease and babesiosis. He was treated aggressively with oral antibiotics as well as intravenous gamma globulin (IVIG), since his serum level of IgG antibodies was low.

After nine years of treatment, the patient had improved substantially. However, any attempt to decrease or discontinue his antibiotics resulted in a relapse of his multi-systemic symptoms within two weeks.

Dr. Liegner explained to the patient that there were no studies investigating disulfiram in the treatment of Lyme disease. But he agreed to treat the patient with appropriate monitoring of his lab tests. The patient began disulfiram 500mg daily and simultaneously discontinued his previous antibiotic regimen. After four months on this regimen, the patient declared, “I’m cured!” and stopped treatment.


Henry
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Re: Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by Henry » Mon 15 Jul 2019 17:37

All should be cautioned that it is easy to find LOTS of things that will kill Borrelia in vitro. Rat poison would be an excellent example. However, some of these "drugs" would be much to toxic to even consider using them to treat patients. Also, unless one does placebo-controlled studies, it is impossible to determine if any of the "beneficial" effects reported by way of testimonials are significant. In the largest clinical trials on the benefit of extended antibiotic therapy for the treatment of post treatment Lyme disease symptoms (PTLDS), the placebo effect was found to be 38%. So, if disulfiram is truly beneficial, one should expect to see an effect at or above 90% to be considered statistically significant. Unless one is dealing with terminal cancer in which there are no treatment options, most drugs approved by the FDA for use in humans have an efficacy of >90%

duncan
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Re: Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by duncan » Tue 16 Jul 2019 13:50

Which is why, I suspect, Fallon is running a study about this particular agent. It's called Science.

Far better than taking all those symptoms in all those late stage Lyme patients and labeling them MUS, then invoking the psych brigade to host a seance in the hopes the ghost of Freud might show.

Henry
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Re: Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by Henry » Tue 16 Jul 2019 16:07

We'll see. In contrast to some of the unproven "unorthodox treatments" that have been proposed, the results of a well-conducted placebo-controlled study certainly would be useful in determining whether this --or other drugs-- eliminate the symptoms associated with PTLDS. My concern is the rationale for using such an approach to eliminate a persisting in vivo infection -- for which there is no evidence-- based on the results of in vitro experiments.

Also, one can easily be mislead by a placebo effect which , in one of the largest clinical studies on PTLDS conducted to date, has been reported to be 38%. To be convincing, Fallon must demonstrate a benefit that is significantly greater than 38%. I'm sure Fallon understands that. It's how evidence-based science works. So, we'll see what happens.
Last edited by Henry on Tue 16 Jul 2019 16:36, edited 1 time in total.

duncan
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Re: Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by duncan » Tue 16 Jul 2019 16:35

As long as you're ok with it when patients have evidence.

Yes, let's see how the Fallon thing plays out. At least there are efforts underway to mitigate the short-comings of standard conventional therapies. Patients before dogma, yes?

Henry
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Re: Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by Henry » Tue 16 Jul 2019 16:46

Actually, alternative approaches are being considered, once one gets beyond the unproven "hang up" of a persistent infection as the one and only mechanism involved : https://medicalxpress.com/news/2019-06- ... tment.html .

duncan
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Re: Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by duncan » Tue 16 Jul 2019 16:51

Just frequently the most likely mechanism.

migs
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Re: Disulfiram: A Test of Symptom Reduction Among Patients With Previously Treated Lyme Disease

Post by migs » Thu 18 Jul 2019 7:00

Persisters makes a lot more sense than this Peptidoglycan persistence (or proliferation?) theory.

It is a cellular component shed by the Lyme bacteria that is causing inflammation...might make sense that this cellular component actually is coming from it’s source.

My god old Steere is really getting desperate.

There is evidence of persistence with BB which I am sure he somehow dismisses but he would like to accept an absolutely unproven theory that a component of BB does persist or even proliferate (??) without the BB itself. Wow...a real scientist at his core!

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