62nd Czeck and Slovak Congress of Rheumatology

Results Presented in Europe

 

Dr Hammond attended the 62nd Czeck and Slovak congress of Rheumatology as the guest of our European partners, EuroPainClinics to present data on the success of DISC-FX treatments in chronic back patients.

After describing the history, investigation and diagnosis of disc-related (discogenic) back pain, audited results from 100 sequentially recorded UK patients treated with DISC FX were reported.

In round numbers, patients were 53% women, average age 45yrs, average overall duration of back pain 5 years and of continuous pain 2yrs. 1, 2 3 and 4 levels were treated and measurements of average and worst back and leg pain, area of pain, disability score and patients perception of global improvement were described. The results are shown in the table below.

62nd Czeck and Slovak Congress of Rheumatology

VariableMeanPercentage improvementWilcoxon (z)
initialfinalp < value
Average Back Pain58.229.349.66.485<0.0001
Worst Back Pain74.739.946.66.254<0.0001
Average Leg Pain36.913.862.75.454<0.0001
Worst Leg Pain41.22051.54.119<0.0001
Area11.35.252.86.479<0.0001
Oswestry (pre/ post)40.127.132.55.235
Average Percentage Global Improvement (%GI)57.4

In each case, the pain scores fell by an average of around 50% and the overall patient rated global improvement was almost 60%. Each of the results were statistically ”significant”. Statistical significance means that an observed change was unlikely to have occurred by chance, leaving the author to argue what did produce the benefit.

In this case, since there is no control group, the observations do not prove that it was my treatment which made the difference, that is simply the common sense position. However, accepting the assumption that it was the treatment that worked, I then showed responder results.

Average figures hide the facts that some patient do well and others do not respond. In this work, 20% of patients did not improve and 5 of them ticked a box to say they were worse while almost 80% stated they were better or much better and a similar 20% were almost 100% better.

Another way of looking at how patients respond is to present response levels, the numbers over 25, 50 and 75% improvement. This responder analaysis is shown below alongside a similar view of a modern trial of the latest biologic therapies in Rheumatoid disease.

“Biologics” are amongst the most effective (and expensive) agents ever used in chronic diseases and showing the results in this fashion was striking to the audience who are now very familiar with these outcomes in Rheumatoid Disease, but will never have seen them in back pain (see below, My results on the blue slide, published results for a major biologic therapy on the right in red).

Finally the published data and my own experience is that once achieved responses are stable and in general people retain the improvements over time.

Results Presented in Europe