Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, November 2, 2014

The Comparative Safety of TNF Inhibitors in Rheumatoid Arthritis - A Meta-Analysis Update of 44 Randomized Controlled Trials

TNF - tumor necrosis factor is the action that Dr. Edward Tobinick  claims is the main problem with recovery from stroke. He uses Etanercept and injects it into the neck in a patented way. This may give your doctor some more information on risks of using this.
http://www.amjmed.com/article/S0002-9343%2814%2900488-4/abstract?rss=yes
,
Young Hee Rho, MD, PhD, MPH
, , ,
Hyon K. Choi, MD, DrPH
Publication stage: In Press Accepted Manuscript

Highlights

  • Adalimumab, certolizumab pegol, and infliximab are associated with a higher risk of serious infection, which appears to contribute to higher rates of discontinuation.
  • In contrast, etanercept showed a lower rate of discontinuation with a tendency towards a lower rate of serious infection.
  • These comparative safety findings should inform clinical and policy decision making in the management of rheumatoid arthritis.

Abstract

Objective

To evaluate and update the safety data from randomized controlled trials of TNF inhibitors (TNFis) in patients treated for rheumatoid arthritis.

Methods

A systematic literature search was conducted from 1990 through May 2013. All studies included were randomized, double blind, controlled trials of patients with rheumatoid arthritis that evaluated adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab treatment. The serious adverse events and discontinuation rates were abstracted, and risk estimates were calculated by Peto odds ratios (ORs).

Results

Forty-four randomized controlled trials involving 11,700 subjects receiving TNFis and 5,901 subjects receiving placebo and/or traditional disease-modifying anti-rheumatic drugs (DMARDs) were included. TNFi treatment as a group was associated with a higher risk of serious infection (OR, 1.42; 95% CI, 1.13-1.78) and treatment discontinuation due to adverse events (OR, 1.23; 95% CI, 1.06-1.43) compared with placebo and/or traditional DMARD treatments. Specifically, patients on adalimumab, certolizumab pegol, and infliximab had an increased risk of serious infection (OR, 1.69, 1.98, and 1.63) and showed an increased risk of discontinuation due to adverse events (OR, 1.38, 1.67 and 2.04). In contrast, patients on etanercept had a decreased risk of discontinuation due to adverse events (OR, 0.72; 95% CI, 0.55-0.93). Although ORs for malignancy varied across the different TNFis, none reached a statistical significance.

Conclusion

These meta-analysis updates of the comparative safety of TNFis suggest a higher risk of serious infection associated with adalimumab, certolizumab pegol, and infliximab, which appears to contribute to higher rates of discontinuation. In contrast, etanercept use showed a lower rate of discontinuation. These data may help guide clinical comparative decision making in the management of rheumatoid arthritis.

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