User talk:24.14.35.45/UVA1 treatment for SLE

Latest comment: 15 years ago by WhatamIdoing in topic General comments
  • [1]
    • Single-patient studies (case studies) are generally not well-regarded as sources; individuals, particularly with an idiosyncratic condition like SLE, generally do not provide for general rules of treatment. Full-text may be more useful however. WLU (talk)
  • [2]
    • Does not mention how many patients; is this only e-published? What's the impact factor of the journal? WLU (talk)
    "Nine Caucasian patients (eight females and one male) with SLE who fulfilled the updated American College of Rheumatology classification criteria for SLE were studied.... All our patients had mild or moderate lupus and had been in a stable condition without any flare for at least 3 months before the study..." Uncontrolled study in patients with limited disease, followed for two months. It's basically a pilot study. This is pretty weak evidence. Impact factors and rankings are here, and it looks good, but I don't know what the IFs are for the comparable journals, and IFs are strictly relative. WhatamIdoing (talk) 21:16, 14 July 2008 (UTC)Reply
  • [3]
    • JEM isn't usually well-regarded from my recall (but I couldn't point you to a specific page saying so); also does not mention lupus in the abstract but it may do so in the main body.
  • [4]
    • This one seems fine, but it would be better if there were studies past 1997 (11 years old now) that followed-up or discussed. This might be where it runs into fringe alarms - if there was evidence in 1997 but it has not generated more and longer-term interest, that may be a reason to doubt it's usefulness or representation in mainstream medicine. WLU (talk)
  • [5]
    • This is about mice; animal studies must be used very carefully as their conclusions must always include the words 'in mice' which limits their applicability to humans. Could be a good reference to 'historical interest' or the origins of the therapy. WLU (talk)
  • [6]
    • This reads as very equivocal evidence to me. Again, UVA1 may be limited by a lack of current interest. Try building a section based on this information and if you let me know, I can give you further opinions on the matter. Be sure to include as many medical sources as you can find. WLU (talk)
    This is probably the best paper of the lot. WhatamIdoing (talk) 21:16, 14 July 2008 (UTC)Reply

References

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  1. ^ McGrath H (2005). "Elimination of anticardiolipin antibodies and cessation of cognitive decline in a UV-A1-irradiated systemic lupus erythematosus patient". Lupus. 14 (10): 859–61. PMID 16304728.
  2. ^ Szegedi A, Simics E, Aleksza M; et al. (2005). "Ultraviolet-A1 phototherapy modulates Th1/Th2 and Tc1/Tc2 balance in patients with systemic lupus erythematosus". Rheumatology (Oxford). 44 (7): 925–31. doi:10.1093/rheumatology/keh643. PMID 15827034. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  3. ^ Morita A, Werfel T, Stege H; et al. (1997). "Evidence that singlet oxygen-induced human T helper cell apoptosis is the basic mechanism of ultraviolet-A radiation phototherapy". J. Exp. Med. 186 (10): 1763–8. PMC 2199141. PMID 9362536. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  4. ^ Molina JF, McGrath H (1997). "Longterm ultraviolet-A1 irradiation therapy in systemic lupus erythematosus". J. Rheumatol. 24 (6): 1072–4. PMID 9195511. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. ^ McGrath H, Bak E, Michalski JP (1987). "Ultraviolet-A light prolongs survival and improves immune function in (New Zealand black x New Zealand white)F1 hybrid mice". Arthritis Rheum. 30 (5): 557–61. PMID 3593437. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  6. ^ Polderman MC, le Cessie S, Huizinga TW, Pavel S (2004). "Efficacy of UVA-1 cold light as an adjuvant therapy for systemic lupus erythematosus". Rheumatology (Oxford). 43 (11): 1402–4. doi:10.1093/rheumatology/keh352. PMID 15304672. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

General comments

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Elevated anticardiolipin antibodies PMID 16304728 cause cognitive problems for lupus patients (the patients themselves call it 'brain fog").
No where else in the literature will you see any other agent positively effect anticardiolipin antibodies.
Single-patient studies can be very important/significant despite the reasons you state, if you really know the disease.24.14.35.45 (talk) 23:45, 14 July 2008 (UTC)Reply
If you really have to know the disease to know the result is important or significant, I would be wary of WP:OR. Also, I deal with most single-patient studies using the wording "in X year, a single patient had/did/was treated with y." My opinion is that from a single patient you can't say anything beyond "X was useful/effective for one person". WLU (talk) 15:42, 15 July 2008 (UTC)Reply
as for "studies past 1997," i think that's when McGrath's NIH funding ran out...it's lack of the possibility of a patient, not effectiveness of the therapy, that has slowed research to a crawl as well as its representation in mainstream medicine..24.14.35.45 (talk) 00:06, 15 July 2008 (UTC)Reply
this will likely only change when a medical device manufacturer seeks FDA approval to market low-dose UVA1 equipment.24.14.35.45 (talk) 15:06, 15 July 2008 (UTC)Reply
PMID 3593437 - absolutely, the mice studies are a great reference to 'historical interest' or the origins of the therapy...so are McGrath's early studies with UV & lupus cells in vitro. 24.14.35.45 (talk) 15:15, 15 July 2008 (UTC)Reply
Great, based on these sources, you can probably draft a section for review to be integrated with SLE. WLU (talk) 15:42, 15 July 2008 (UTC)Reply
I still don't think we're any closer to this being mentioned on the lupus page. We are looking either for a fairly large case series with objective measurements of improvement in lupus severity, or alternatively a source that states unequivocally that UVA1 light therapy is being used by a significant proportion of lupus patients worldwide. Neither of those studies seems to exist. JFW | T@lk 16:05, 15 July 2008 (UTC)Reply
Indeed, but better a draft section be created and reviewed than simply edit warring on the page and end up blocking the IP. With these sources it's at least worth discussing, but difficult to discuss without a properly referenced section. WLU (talk) 16:24, 15 July 2008 (UTC)Reply
I'm not convinced that this is really useful. We need much better sources. They don't exist. Whatever we might write now will have to be scrapped when, in five or ten years, we (presumably) have much better sources. This is sort of like saying "Finish the documentation on the new product today. I won't actually design it until next week, but you can just make some logical assumptions." WhatamIdoing (talk) 05:05, 17 July 2008 (UTC)Reply