If you’ve been following the story of liberation therapy for MS, we have now come to what is conceivably the end. Eight years after the original W5 segment made this dubious MS treatment widely popular, the scientific evidence is in.
Read the full story in the Montreal Gazette here: http://montrealgazette.com/opinion/opinion-myth-of-liberation-therapy-fo…
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Well, it’s finally over. It took eight years, but I think we might actually be done. Liberation therapy will hopefully fade into obscurity as one of the many medical myths that seem absurd when you look at them in retrospect.
If you have forgotten the story, everyone was talking about liberation therapy in November 2009 when a segment aired on CTV’s W5 program. The claim was that narrowed veins in the neck caused multiple sclerosis. Opening up these narrowed veins would therefore treat MS.
The media coverage was almost glowingly positive. Governments rushed to be seen as proactive and dedicated millions of dollars in public money to fund research into the treatment. The prevailing media narrative framed it as a “war” between patients and the medical establishment. Patient groups called for its widespread adoption and some travelled to other countries to get the therapy that was not approved in Canada.
The whole episode was sadly disappointing. The evidence behind liberation therapy was surprisingly weak, but that didn’t stop people from declaring it a game-changer. The original W5 program referenced a 2009 study by Paolo Zamboni, who claimed that MS patients improved after having their veins unblocked. But it was a non-randomized, non-blinded study trial with no comparison group. For obvious reasons, those of us who looked at the research were far from impressed.
Apart from the weakness of the evidence, the theory itself made little sense conceptually. First off, you would have to ignore all the evidence that suggests multiple sclerosis is an immune mediated disease. Just last year, research from Ottawa demonstrated how stem-cell transplants might prove useful in treating MS. The data are still preliminary and must be proved in larger clinical trials, but they suggest a promising avenue toward a potential new treatment.
But more important, the claims for liberation therapy were based on shaky evidence that did not hold up to scrutiny. First a study from Newfoundland found no benefit among 30 MS patients who were treated with liberation therapy. Then another study from British Columbia found that narrowed veins were not any more common in MS patients than in the general population. The B.C. researchers then followed up with another study showing that ballooning open these blockages had no effect on MS patients when compared to a placebo procedure.
The final nail in the liberation therapy coffin came recently in the journal JAMA Neurology. The study was a randomized, double-blind, sham-controlled trial in six centres throughout Italy. It failed to show any benefit to vein liberation therapy. But the study is most noteworthy because the first author is none other than Paolo Zamboni.
It is rare for scientists to try to debunk themselves. Zamboni’s conclusion to the paper was clear and unambiguous: liberation therapy is a “largely ineffective technique; (and) the treatment cannot be recommended in patients with MS.”
In my mind, he deserves slightly more praise than he has received. It is not easy to repudiate yourself and disprove your own prior research. I think few people would have the courage to do so.
No doubt he should have been more circumspect in his media interviews in 2009. But then again, perhaps he should not have been put on TV in the first place. If his reversal is grudgingly obtained and a bit late in coming, it should be noted that many people are never willing to concede their own research is flawed.
If there’s a…
