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Cell Therapy News/Articles, page-13522

  1. 7,919 Posts.
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    Thanks for the reply

    1) Risk vs benefit will be hard to gauge when benefit isn't yet proven. If in the next phase 3 they can show more evidence then I'll be much more convinced.

    2) I've never had objections to local injections treating local things. For example, I've never mentioned systemic infusions for CLBP.

    The problem I have is that the local injection was chosen as such because it was theorised to have a local effect on the inflammatory processes driving the progression of heart failure. That was not shown to be the case.

    What they did find was decreased risk of MACE and stroke. Which is interesting and needs further investigation, but that doesn't fit with the theory that they initially postulated.

    They haven't come up with a proposed mechanism that would account for this, that would need a local injection vs a systemic infusion.

    And no matter what anyone says here, a systemic infusion, if it were as effective as a local injection, would be safer for patients, much less costly (by a factor of ten in America, do you know how much a cardiac catheterisation costs vs an infusion?), and much better for the company by increasing the potential market.

    It's baffling to me why they wouldn't consider it now that they're seeking different endpoints. And maybe I'm misunderstanding their train of thought, but that's because they haven't explained it to investors. It's just being accepted blindly when it actually doesn't make sense (the mechanism was also questioned by the independent panel of experts, I'm not the only one).

    It would bypass the pulmonary first pass effect of course. But that doesn't really seem to be an issue when it's given for aGVHD. And they could give it during cardiac Cath into the LV without directly injecting into the myocardium, allowing for a much higher dose systemically without risk of direct cardiac injection.

    3) Again, it didn't seem to affect progression of heart failure, so this point is moot. I agree local injection for perinatal fistula would be ideal, or even an arterial infusion into SMA/IMA via interventional radiology for chron's as that often affects large portions of the bowel.

    And I'm glad you've done an undergrad in med science, and this is likely why you bring up interesting points. But despite my qualifications and experience I don't consider myself an expert at any of this stuff. I just know one side of the health system, and I know how to critically analyse papers.

    And I know how to listen to the independent experts, who were also very skeptical of these results.
    Last edited by DocMcstuffins: 17/05/22
 
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