The Convoluted Games That Researchers Play

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tex
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The Convoluted Games That Researchers Play

Post by tex »

Hi All,

Most of us are well aware that Alba Therapeutics (created to bring Dr. Fasano's anti-zonulin pills to market) is in the final stages of testing Larazotide Acetate in order to receive FDA approval for the product. So once again they are seeking test subjects for the latest trial. But look at the selection criteria for test subjects, especially the items that I have highlighted in red:
Eligibility

Ages Eligible for Study: 18 Years to 75 Years
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria (select criteria, not all inclusive):

biopsy proven and serology-confirmed celiac disease (at any point in time prior to study entry)
written informed consent
age between 18-75
BMI between 18.5-40
symptoms despite being on a gluten-free diet (diarrhea, nausea, stomach pain, bloating)
must have attempted a gluten-free diet for at least 12 months
CeD-GSRS score

Exclusion Criteria (select criteria, not all-inclusive):

Refractory celiac disease
diagnosed with chronic active GI disease, such as irritable bowel syndrome, inflammatory bowel disease etc.
severe complications of celiac diseases
They are saying that subjects must have the symptoms of celiac disease, even though they are on a GF diet, but they can't have refractory celiac disesase. Well Doh! Either I don't understand the definition of "refractory", or somebody is playing games with the selection process.

Just for a reality check, I decided to see how Webster defines the word "refractory":
refractory adj., n., pl. ries. -adj. 1. hard or impossible to manage; stubbornly disobedient: a refractory child. 2. resisting ordinary methods of treatment. 3. difficult to fuse, reduce, or work, as an ore or metal. -n. 4. a material that retains its shape and composition even when heated to extreme temperatures. 5. refractories, bricks of various shapes used in lining furnaces
So in view of that definition, it seems pretty clear that if we apply that definition to someone with celiac disease, a patient showing signs of a "refractory" condition would continue to show symptoms of the disease, such as "diarrhea, nausea, stomach pain, bloating", "despite being on a gluten-free diet".

Are they taking out of both sides of their mouth at the same time, or am I nuts?

http://www.clinicaltrials.gov/ct2/show/ ... AUS&rank=2

The project must be continuing to encounter problems, because I see by the History of changes for the project that they have changed the recruitment criteria and a couple of other items again, almost a year after the recruitment announcement was first issued. Gee, I wonder if the convoluted recruitment criteria might have anything to do with that. :lol:

http://clinicaltrials.gov/archive/NCT01396213

In view of these weird selection criteria, how in the world could anyone in their right mind be expected to trust the results of the trial?

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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MBombardier
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Post by MBombardier »

Your last question is exactly what I was thinking as I read. Another question I have is, what good is a medicine for such a narrowly-defined population (once they figure that out), and what kind of problems will pop up when/if it is prescribed for people who do not fit that definition?
Marliss Bombardier

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Post by MaggieRedwings »

They just never cease to amaze me!

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Post by JFR »

This really makes no sense. Is the diagnosis of "refractory celiac disease" somehow more specific than just having symptoms despite being gluten free? I know that it is a general problem in drug research that the criteria for inclusion in a clinical trial are so specific and severe that the results can't really be generalized to the target group, which of course happens anyway. This is certainly true when testing anti-depressants.

Jean
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