Saturday, 13 August 2016

Survey Results & Wound Healing

#MSresearch Do DMT slow wound healing?

I was speaking with someone with MS and they asked "Is there any evidence that drugX affects healing of scratches", because when they do their nails they notice that any scratches from scissor work takes time to heal.. 
This is a stock photo and no someone on a DMT

I said I don't know and asked ProfG to run a survey for me:





He sent me the link to the results and I was going to give you a graph of the results drug by drug, which shows what you might think and re-inforces what ProfG said that if you take a drug that blocks your immune system, then things that your immune system do, such as wound healing, might be slow.

However, last week we had a lab meeting where we was discussing a case report of someone in our care. We asked someone from pharma to talk about whether the effects we saw was a common occurrence. During the visit we were told because we had brought this case up, it needed to be recorded as an adverse event as part of the company's pharmacovigilance, where companies record every adverse event. In many cases the event is unrelated to the action of a drug, for example a car crash of someone in a trial would be reported, but they may not have even taken the drug. However if you got a lot of car crashes then it may be cause of the drug, such it may cause a blackout and so it could be drug related.


So is slow wound healing an adverse event? 

I have had a quick look as some of the drugs mentioned in the survey and did not see any mention of slow wound healing on their data sheets, so what I am about to say may ring an alarm bell. 

However, based on what was found I think there is a common pattern, and therefore I am not going to mention names, so hopefully ProfGs phone is not ringing by the time this is posted.

Therefore, I have decided to  cluster them into: CRAB (Low efficacy) Drugs, High efficacy Drugs (maintaining immunosuppression by repeated treatments) and Induction Drugs (High efficacy but not taken constantly to maintain immunosuppression)  and report on slow wound healing

The results are
______________________________________________________
Drug Class                       Frequency of Slow Wound Healing 
______________________________________________________

CRAB Drugs                                         20% 

High Efficacy Drugs                             55% 

Induction Therapies                             29%
______________________________________________________


The survey sample size was small and has margins for errors, but the data was consistent with the known potencies of the different drugs.

The CRAB drugs were different from the High efficacy drugs (P<0.05), using uncorrected Chi-squared.

The result with the induction therapies was interesting because although they are high efficacy, once the drug is gone the immune system returns and so is available to heal scratches, however maintaining use of the high efficacy drugs were consistent with their influence on wound healing. 

So well spotted by the person asking the question as they seem to have spotted something. Maybe pharma will investigate because they have high numbers users and by analyzing a large sample it may mask any bias of you the readers in our small survey.

Thank you for taking part.

5 comments:

  1. The induction therapies almost had the same result of CRABS.
    I see it as a point most favorable to the induction therapy, it has high efficiency and yet would hurt the healing process.

    ReplyDelete
  2. I took the survey and stated that I did not have any trouble with wound healing. I'm on Tysabri and have been for over 5 years. Very soon after I took the survey, it was discovered on my most recent MRI that I had an infection of the left maxillary sinus. After looking at the pictures for the last 2 years, we discovered I've had this infection for the whole time! So, can that count as slow wound healing? I wonder how many other folks on natalizumab has similar experiences?
    Thanks for the blog, I love it!

    ReplyDelete
    Replies
    1. i'm not going to give individual figures in case a spark a pharmacovigilence problem for every MS drug :-(

      Delete
  3. I would still like to know how to get rid of warts. After my last freezing session, the wart finally blistered, but underneath the original wart was still there and two new friends had joined. We are going to try blister beetle in a few weeks time. Will let you know how it goes.

    ReplyDelete
  4. Are similar processes used in wound healing as in fighting off bacterial infections?

    ReplyDelete

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