Angry Doctor

Friday, September 19, 2008

Loss 3

The Straits Times, which angry doc is given to understand is "waging a vociferous campaign against alternative therapies for autism", reported this piece of news off Associate Press yesterday. Curiously, the editor had decided to leave out two paragraphs from the AP report, which angry doc had highlighted in blue.

Controversial autism study 'off'

CHICAGO - A US government agency has dropped plans for a study of a controversial treatment for autism that critics had called an unethical experiment on children.

The National Institute of Mental Health said in a statement Wednesday that the study of the treatment - called chelation - has been abandoned.

The agency decided the money would be better used testing other potential therapies for autism and related disorders, the statement said.

'There will be parents who are disappointed,' said Dr Richard Nakamura, the scientific director of NIMH. 'We recognize that for children there is a fine line for the risk-benefit ratio. You have to be pretty certain of the overall safety of the procedure.'

The agency wasn't confident enough in the procedure's safety, Dr Nakamura said.

The study had been on hold because of safety concerns after another study published last year linked a drug used in the treatment to lasting brain problems in rats.

Chelation removes heavy metals from the body and is used to treat lead poisoning.

Its use as an autism treatment is based on the fringe theory that mercury in vaccines triggers autism - a theory never proved and rejected by mainstream science.

Mercury hasn't been in childhood vaccines since 2001, except for certain flu shots.

But many parents of autistic children are believers in the treatment, and NIMH agreed to test it.

The researchers had proposed recruiting 120 autistic children ages 4 to 10 and giving half a chelation drug and the other half a dummy pill.

The 12-week test would measure before-and-after blood mercury levels and autism symptoms.

The study outline said that failing to find a difference between the two groups would counteract 'anecdotal reports and widespread belief' that chelation works.

Autism is a spectrum of disorders that hamper a person's ability to communicate and interact with others.

Most doctors believe there is no cure.

In cancelling the study, the agency noted it would take another year to review the study and three years to do it.

In the meantime, the agency said, it was likely that other research would 'provide deeper understanding of the causes of autism and more refined avenues for developing treatments.'

NIMH should reconsider its decision to cancel the chelation study, said Rebecca Estepp, national manager of Talk About Curing Autism, a support group for families with autistic children.

"By discontinuing this study, the NIMH will not prove the effectiveness of chelation therapy one way or another. Instead, they have merely left parents with more unanswered questions," Estepp said in a statement.

Several scientists praised the decision, including the lead author of the rat study, which found lingering problems in animals that did not have elevated lead levels.

'I think they're making the right decision not to go forward with the study,' said Prof Barbara Strupp, a professor of psychology and nutritional sciences at Cornell University.

'Our data raise concerns about administering (the chelation compound) to children who do not have elevated levels of heavy metals,' Prof Strupp said.

Dr Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia, agreed with the decision to cancel.

'Suppose that a child suffers a severe side effect from chelation,' said Dr Offit, author of Autism's False Prophets, a new book on autism research.

'Without any evidence it's helpful, I think it's unethical.' The chelation drug proposed for the study, DMSA, can cause side effects including rashes and low white blood cell count.

'This was a wise and careful decision,' said Professor Ellen Silbergeld of Johns Hopkins University's Bloomberg School of Public Health, who had been invited to comment on the study during an earlier review, in an e-mail. -- AP

angry doc is unsure whether if the decision is a win or a loss in the "campaign against alternative therapies". On the one hand funding for a study which carries a potential risk towards children but has little biological basis for a cure had been discontinued, but on the other hand such a decision allows proponents of "alternative therapies" to continue to promote their business - since it has not been "disproven" - and even to portray this as a part of a conspiracy by the government and the medical and scientific communities to deny children with autism a chance at a cure.

In fact, they already have.

angry doc wonders when our local proponents and practitioners of "alternative therapies" will chime in.

angry doc also wonders if, had the study not been discontinued and the result had shown that chelation did not cure autism, proponents of chelation for treatment of autism will accept the evidence and renounce their claims. Past experience does not allow angry doc to be optimistic, so perhaps it is a good thing that the study had been stopped after all.

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