Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
X-member
Posts: 8349
Joined: Mon 30 Jul 2007 18:18

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by X-member » Thu 30 Apr 2015 16:07

From the ECCMID-conference in Copenhagen 25-28 April 2015.

"Anneleen Berende
Persistent Lyme Empiric Antibiotic Study Europe (PLEASE) - a randomized controlled trial of prolonged antibiotic treatment in patients with persistent symptoms attributed to Lyme borreliosis || Oral Presentation"

http://eccmidlive.org/resources/persist ... eliosis--2

Martian
Posts: 1944
Joined: Thu 26 Jul 2007 18:29
Location: Friesland, the Netherlands

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by Martian » Thu 30 Apr 2015 16:19

X-member wrote:From the ECCMID-conference in Copenhagen 25-28 April 2015.
Thanks, X-member. That is probably the best source of information about the study results at this moment. I will check it out.

FYI: the presentation is 10 minutes long. After that questions are answers for 4 minutes.

User avatar
ChronicLyme19
Posts: 564
Joined: Mon 11 Aug 2014 17:42
Location: NY, USA

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by ChronicLyme19 » Thu 30 Apr 2015 21:31

Patients either had to have:
1) Temporally related (<= 4 months) to proven Lyme borreliosis
2) IgM or IgG Borrelia antibodies (confirmed by immunoblot)

What specifically do they mean by #1, was this limited to bullseye rash only? For #2, how many bands did they have to show? Which ones? This still goes back to questioning the subset of patients that they choose to study. They would have thrown a patient out like me, who has an immune deficiency. I have certainly benefitted from longer antibiotics.

Also, it definitely does look like the patients improved during the treatment period vs afterwards and that they are just saying that the improvement wasn't great enough. Or that that change was solely due to a placebo type effect of having an IV in their arm? I mean you really don't know unless they gave someone IV saline solution and tracked the delta right?
Attachments
slide 26.JPG
slide 26.JPG (33.12 KiB) Viewed 3181 times
Half of what you are taught is incorrect, but which half? What if there's another half missing?

radicale
Posts: 134
Joined: Fri 4 May 2012 16:51

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by radicale » Thu 30 Apr 2015 22:24

This result is very disappointing, in part contradictory to what has been published by Sam Donta, and quite frankly crystal clear to me. There is no clear benefit or rational, for a large group of patients who may seek out this treatment, for taking up to three months of doxy or clarithomycin + planquil after receiving two weeks of ceftriaxone. When one looks at the available evidence it would be hard to take a doctor seriously if they prescribed any of these combinations.

X-member
Posts: 8349
Joined: Mon 30 Jul 2007 18:18

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by X-member » Thu 30 Apr 2015 23:04

radicale wrote:
When one looks at the available evidence it would be hard to take a doctor seriously if they prescribed any of these combinations.
I think it is more stupid to do a study, and (as it looks like in this case) don't include any patient that have signs of a still active borrelia infection after treatment. We do not need any more studies on the wrong patients.

radicale
Posts: 134
Joined: Fri 4 May 2012 16:51

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by radicale » Thu 30 Apr 2015 23:13

X-member wrote:radicale wrote:
When one looks at the available evidence it would be hard to take a doctor seriously if they prescribed any of these combinations.
I think it is more stupid to do a study, and (as it looks like in this case) don't include any patient that have signs of a still active borrelia infection after treatment. We do not need any more studies on the wrong patients.
A large portion of patients (from the study) had persisting symptoms after earlier treatment, presumed to be due to an active borrelia (or some other) infection.

BTW, that is the whole point of this debate, are the persisting symptoms due to an active infection or something else...

X-member
Posts: 8349
Joined: Mon 30 Jul 2007 18:18

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by X-member » Thu 30 Apr 2015 23:23

radicale wrote:
A large portion of patients (from the study) had persisting symptoms after earlier treatment, presumed to be due to an active borrelia (or some other) infection.
Symptoms (without signs of a still active infection) after a successful treatment actually exists. It is maybe even more common (especially if we talk about a neuroborreliosis) than treatment failure.

Martian
Posts: 1944
Joined: Thu 26 Jul 2007 18:29
Location: Friesland, the Netherlands

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by Martian » Thu 30 Apr 2015 23:51

X-member wrote:radicale wrote:
When one looks at the available evidence it would be hard to take a doctor seriously if they prescribed any of these combinations.
I think it is more stupid to do a study, and (as it looks like in this case) don't include any patient that have signs of a still active borrelia infection after treatment. We do not need any more studies on the wrong patients.
The patients of the PLEASE study resemble patients in Lymeland who seek longer term treatment by seeing so-called "llmds". Some of the patients were/are also active on Lyme disease forums.

However, the patients of the PLEASE study typically did not have an established, but a presumed persistent Lyme disease. But that corresponds perfectly with common practice.

Well actually, in case of the patients of the PLEASE study al least it is established that they have had Lyme disease, which cannot be said of many people in Lymeland.

X-member
Posts: 8349
Joined: Mon 30 Jul 2007 18:18

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by X-member » Fri 1 May 2015 0:15

According to Swedish experts, 1 % of the borreliosis cases have treatment failure (I think it is more). Based on the latest estimated number of borreliosis cases in Sweden (40 000/year), there are more cases each year with a persistent, active borreliosis in Sweden, than was included in the PLEASE-study. So it should be possible to do a study on cases that actually have persistent, active borreliosis after treatment.

X-member
Posts: 8349
Joined: Mon 30 Jul 2007 18:18

Re: Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)

Post by X-member » Sat 2 May 2015 14:19

http://www.lymeneteurope.org/forum/view ... =50#p42049

ChronicLyme19 wrote:
Also, it definitely does look like the patients improved during the treatment period vs afterwards and that they are just saying that the improvement wasn't great enough.
I agree, but did the patients included in this study need more than 14 days of abx (IV in this study)?

Post Reply