‘Liberation Therapy’ for MS Is Ineffective Despite Cost and Risks, Study Finds

‘Liberation Therapy’ for MS Is Ineffective Despite Cost and Risks, Study Finds

Liberation therapy was seen to be an ineffective treatment — both in the short and long term — in a Canadian study in people with multiple sclerosis (MS), its researchers reported, advising patients not to assume the procedure’s risks or cost.

Lindsay Machan, a radiology professor at the University of British Columbia (UBC), presented results of his team’s study during the March 4-9 annual meeting of the Society for Interventional Radiology in Washington, D.C.

Liberation therapy, a controversial angioplasty procedure, stems from the belief that MS patients have chronic cerebrospinal venous insufficiency (CCSVI), a condition of compromised blood flow in veins flowing away from the central nervous system. Since 2009, thousands of patients have had their neck veins dilated through this one-time operation, which aims to improve blood flow between the brain and the heart, and clear out iron deposits.

However, there is no clear evidence of the relationship between CCSVI and MS, and Canadian doctors have refused to perform this surgery on the grounds it is unnecessary and potentially dangerous — prompting some patients to seek the treatment in the United States, Latin America and Eastern Europe.

Machan’s $5.4 million study — jointly funded by the Canadian Institutes of Health Research, the MS Society of Canada and the provinces of British Columbia, Manitoba and Quebec — enrolled 104 participants with MS who were randomly assigned to receive the liberation procedure or a sham operation that mimics the procedure but with no actual surgery. Doctors performed the procedure on either the jugular vein, which transports blood from the brain, or the azygos vein, which transports blood from the spinal cord.

All participants had a catheter inserted into their blocked veins, but only 49 patients underwent actual blood vessel surgery, in which blood vessels were opened up by inflating a small balloon. Since the study was double-blinded, neither the patients nor the physicians who evaluated them knew who was receiving the actual treatment or the sham procedure.

One year after surgery, doctors assessed patients’ blood vessels using brain imaging, MS symptoms and self-reported evaluations. Although patients in both groups reported slight improvements, doctors’ analyses found no difference in MS symptoms between sham and liberation therapy groups — neither at three days after the procedure nor one year later.

Brain assessment using magnetic resonance imaging also showed no improvement in the treatment group compared to sham group, not after six months or one year later. Together, these findings show liberation therapy to be ineffective in treating blood vessel anomalies in MS patients.

“We hope these findings, coming from a carefully controlled, ‘gold standard’ study, will persuade people with MS not to pursue liberation therapy, an invasive procedure that carries the risk of complications, as well as significant financial cost,” UBC neurology professor Anthony Traboulsee said in a news release. “Fortunately, there are a range of drug treatments for MS that have been proven through rigorous studies to be safe and effective at slowing disease progression.”

It’s not the first time researchers address the possible relationship between CCSVI and MS. In 2013, another study, supported by the MS Society of Canada, showed that MS patients and healthy people have similar degrees of blood vessel narrowing.

“Despite the negative findings of that diagnostic study, many patients wanted to know if the venous dilation procedure could help,” Machan said. “We were committed to meticulously evaluating this treatment with robust methods and patient-focused outcomes.”

10 comments

  1. Malcolm Roberts says:

    I doubt these comments will be left on this page or published, but
    I have to respond: your article states there is… “no clear evidence”…. of CCSVI and MS: perhaps you could publish where the “Auto-Immune” hypothesis has ever been proven and that is the true cause of MS ?? You also quote Traboulsee’s comments re the “range of drug treatments” available, and again please publish how this $20 BILLION industry has cured MS sufferers and how many have died through these treatments ??

    • Rebecca Welsh says:

      I’d like to see an article about the auto-immune designation of MS because I have heard it is not an ‘äuto-immune disease.’

    • Filippo FUNARO says:

      Nice to see how many articles and comments on this study not yet published, based on 104 patients and with 1 year follow up,
      while I still see so few about this study based on 366 patients, with a 4 years follow up and already published:
      “May symptoms of chronic cerebrospinal venous insufficiency be improved by venous angioplasty? An independent 4-year follow up on 366 cases” (Veins and lymphatics).
      …maybe this also depends on the placebo effects…

  2. Filippo FUNARO says:

    Interesting to see how many articles and comments about this study based on 104 patients, with 1 year follow up and not yet published….while still is difficult to find an article about this study besed on 366 patients, with a 4 years follow up and already published:
    “May symptoms of chronic cerebrospinal venous insufficiency be improved by venous angioplasty? An independent 4-year follow up on 366 cases” (Veins and lymphatics).
    is this also a placebo effect?

  3. Filippo FUNARO says:

    I already sent twice so I really doubt these comment will be left on this page or published, but, again:
    Nice to see how many articles and comments on this study not yet published, based on 104 patients and with 1 year follow up,
    while I still see so few about this study based on 366 patients, with a 4 years follow up and already published:
    “May symptoms of chronic cerebrospinal venous insufficiency be improved by venous angioplasty? An independent 4-year follow up on 366 cases” (Veins and lymphatics).
    …maybe this also depends on the placebo effects…

  4. Bobbi says:

    If there is no benefit from liberation therapy them I ask you to look at the before and after YouTube videos of people who have undergone the treatment.

  5. jake mit says:

    so…

    “Machan’s $5.4 million study — jointly funded by the Canadian Institutes of Health Research, the MS Society of Canada and the provinces of British Columbia, Manitoba and Quebec”

    Anyone notice how the MS Society funded this so called research? the one that wants you buy there drugs, they so call “help” reduce MS side effects or eliminate them but have no long term scientific proof that they do and yet they cost thousands of dollars and stuff them down our throats. if this therapy helps in anyway it should be explored and done. its bad enough we have to look forward to a possible wheel chair in the future while we make them rich and have less time with our family’s.

    its all about diet, stick to it.

    just something that crossed my mind.

    cheers

  6. Alex M says:

    (1) The paper Filippo keeps going on about has numerous methodological flaws, ranging from a lack of a control group to the exclusive use of symptom-self report.
    (2) There is no clear link between CCVSI and MS, as the article says
    (3) There are youtube videos claiming many things. Trained physicians, not patients, usually have a better idea of what precipitates a “cure”. This is particularly true for relapsing-remitting MS, where symptoms can come and go with no explanation.
    (4) The MS society is comprised of patients, advocates, and family members who all have a very strong interest in seeing MS cured. Keep your conspiracy theories on the flat earth blogs.

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