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ElectroCore - New Treatment (Read 2553 times)
Traveller
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ElectroCore - New Treatment
Feb 24th, 2015 at 7:56pm
 
A friend who knows of my affliction sent me this.  Sounds like something akin to an ONB, but without incision, drugs, and needles.  Promising, let's hope it develops.

Clinical trial shows electroCore’s non invasive vagus nerve stimulation therapy is effective in reducing cluster headaches

by qvi, electrocoremedical.comJune 10

NEW JERSEY. In a multi-center, randomized, trial across Europe, electroCore’s non-invasive vagus nerve stimulation (nVNS) therapy was found to meet its primary endpoint of statistical significance in reducing the number of cluster headache attacks when compared with the standard of care1. During weeks three and four following the beginning of therapy, the number of cluster headache attacks per week was reduced by 46.3% in patients treated with nVNS compared with 12.5% (p=0.002) in patients treated with the best available standard of care.

Dr. Charly Gaul, Director of the Migraine and Headache Clinic Königstein, Germany and the principle investigator of the study commented; “This study is one of the few well controlled, randomized studies of any preventative treatment for cluster headache. The ability of electroCore’s gammaCore therapy to significantly reduce the number of weekly cluster headaches in these chronic patients suggests it offers an important new option for this extremely painful and difficult to manage condition.”

The trial – PREVA2- which was conducted at ten sites across Europe was investigating both the prevention and acute treatment of chronic cluster headache. Patients delivered the nVNS treatment by placing the gammaCore device on the skin over the vagus nerve in the neck prophylacticly twice daily (three stimulations per treatment) and optionally at the onset of a cluster headache. The trial enrolled 97 patients, and 93 were randomized to participate beyond the initial baseline data collection period. Forty five of the patients were randomly selected to use gammaCore and 48 to the best available standard of care. The baseline data collection period was two weeks, followed by the four week randomized phase. All subjects were permitted to continue on active therapy for an additional four-weeks.

The primary efficacy end point was the reduction in number of cluster headache attacks per week during the last two weeks of the randomized phase versus the baseline period. Additional end points included the proportion of subjects with more than 50% reduction in cluster headache attacks per week (response rate). Device related adverse events were primarily mild and transient. Full data from the randomized and open label portions of the study will be presented at medical meetings later this year. JP Errico, the Chairman and CEO of electroCore noted; “We are pleased with these study results in which gammaCore has demonstrated a statistically, and more importantly, clinically significant result. This study represents our first in a series of pivotal multi-center studies in cluster headache. We look forward to the full presentation of this data, as well as the data from our three other randomized clinical trials in both cluster headache and migraine. We are continuing to explore the efficacy of nVNS in a range of related diseases and disorders.”

ElectroCore’s proprietary, non invasive electrical stimulation therapy works by activating specific fibers in the vagus nerve bundle. Vagus nerve stimulation has been shown by electroCore and others to enhance the release of inhibitory neurotransmitters within the central nervous system, and electroCore has previously demonstrated that nVNS reduces excessive expression of the excitatory neurotransmitter glutamate, which has been implicated in a number of different disorders.

1 A diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance.2 PREVA – electroCore’s Prevention and Acute Treatment of Chronic Cluster Headache study carried out at ten sites across Europe.
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lancashire Lad
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Re: ElectroCore - New Treatment
Reply #1 - Feb 24th, 2015 at 8:20pm
 
New treatment for migraine came up with a 62.5% reduction in headaches but in the same trial the placebo managed a 42.3% reduction in headaches.

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Therein lies a problem
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Hoppy
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Re: ElectroCore - New Treatment
Reply #2 - Feb 24th, 2015 at 8:53pm
 
They are talking about patients who suffer from chronic
cluster headaches, and with a decrease of 46.3% of
attacks in a week, is better than no relief at all in
my book.

Hoppy.
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« Last Edit: Feb 24th, 2015 at 9:52pm by Hoppy »  
 
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jon019
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Re: ElectroCore - New Treatment
Reply #3 - Feb 24th, 2015 at 9:09pm
 
lancashire Lad wrote on Feb 24th, 2015 at 8:20pm:
New treatment for migraine came up with a 62.5% reduction in headaches but in the same trial the placebo managed a 42.3% reduction in headaches.

Therein lies a problem



Mebbee....mebbee not. Lots of factors involved (e.g. cost, convenience, willingness, source, etc, etc)....I personally don't care if something works for me because I THINK it does...or it has some actual action. Apologies upfront because I know some here will be horrified by that comment......but note that I never tried the tinfoil or blue cheese, and put the cayenne powder away long ago.
Shhhhhh....don't tell anybody...but I've even been known to rely on anecdotal evidence....or what's a ch.com for................

The mind is a way more potent instrument than we have, or perhaps ever will, imagine...and drug researchers/developers COUNT on the placebo effect. In some cases for a LARGE part of the efficacy.

Best

Jon
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Mike NZ
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Re: ElectroCore - New Treatment
Reply #4 - Feb 25th, 2015 at 12:01am
 
Traveller wrote on Feb 24th, 2015 at 7:56pm:
NEW JERSEY. In a multi-center, randomized, trial across Europe, electroCore’s non-invasive vagus nerve stimulation (nVNS) therapy was found to meet its primary endpoint of statistical significance in reducing the number of cluster headache attacks when compared with the standard of care1. During weeks three and four following the beginning of therapy, the number of cluster headache attacks per week was reduced by 46.3% in patients treated with nVNS compared with 12.5% (p=0.002) in patients treated with the best available standard of care.

1 A diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance.


So they did the comparison to a non-specified treatment. I wonder what it was, especially as the standard of treatment from most non-headache specialists is very often poor.

I wonder how well the treatment would work compared to someone say having a prednisione taper dose plus verapamil at the appropriate level with oxygen / imitrex injections for aborting?

I wonder how well it would do compared to D3?

The devil is in the detail of any trial like this.
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AussieBrian
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Re: ElectroCore - New Treatment
Reply #5 - Feb 25th, 2015 at 12:59am
 
A new process, a new procedure, a new possibility that something might help us.

A new cause for hope.

Let's not write this off without at least giving it a chance. It may have some worth, and even a 1% improvement is something to be applauded.

Of all the glasses that are half-empty, some are half-full, and we've little to lose by being open minded.

While it does no harm...
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My name is Brian. I'm a ClusterHead and I'm here to help. Email me anytime at briandinkum@yahoo.com
 
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Peter510
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Re: ElectroCore - New Treatment
Reply #6 - Feb 25th, 2015 at 4:42am
 
Hi there,

I posted a piece on this on 9th January ( under the medications and treatments section) entitled gammaCore, if you want to go back and have a look.

Been using the device for a couple of years now as a very portable, effective and expensive abortive.

My recent adventures with the D3 Regimen has rendered the device virtually obsolete for me, but it saved me a whole lot of pain in the past.

Sorry, I'm not that Techno Savvy, so I don't know how to merge my post of 9th January, with this one.

Peter.
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lancashire Lad
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Re: ElectroCore - New Treatment
Reply #7 - Feb 25th, 2015 at 8:21am
 
Vagus Nerve Stimulation VNS has been around for a number of years, first use for Epilepsy and then Depression.

Two modes; non invasive (electrodes pressed on the neck) and Invasive (electrodes placed in neck with generator in chest). Similar to TENS I guess but expect to be corrected if I'm not. Proprietary pulse wave forms don't make it dissimilar to TENS for me

Like Electro-convulsive Therapy (ECT) the reasons why it works are little or not understood but for some people it works.

The non invasive has a distinct disadvantage of ever having the curative properties known as its effects has the ability to stimulate a whole lot of other things in and around the brainstem. So if it works, is it the Vagus nerve that is doing the job or doesn't it matter? (This is true to a lesser degree to the implanted version and the proximity effect on other nerves)

But it is the stimulation of the Brainstem that interests me (and presumably others). Doing stuff to the neck definitely elicits beneficial responses in some CH sufferers (and/or possible misdiagnosed CH sufferers.

I agree with Goadsby (for once) it would be nice if the Neurologists spent a bit more time in the Pain Specialists canteens. (Goadsby paraphrased from Lancet Oct 2009 )
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lancashire Lad
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Re: ElectroCore - New Treatment
Reply #8 - Feb 25th, 2015 at 8:34am
 
Recent VNS study

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tangerinearmy
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Re: ElectroCore - New Treatment
Reply #9 - Feb 25th, 2015 at 9:12am
 
i,ll stick to busting and D3

each to their own mind
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