My only commentary would be that these results do not read like clinical success, but rather something suggesting they should move on to phase III clinical trials.
This is the only publication I found in a quick search:
Objectives: Nerve growth factor β (β-NGF) is a protein which is important to the development of neurons particularly those involved in the transmission of pain and is central to the experience of pain in osteoarthritis (OA). Direct NGF antagonism has been shown to reduce OA pain but is associated with rapidly progressive OA. The aim of the study is to investigate the ability of soluble neurotrophin receptors in the NGF pathway to modulate pain in OA.
Methods: Synovial fluid (SF) was obtained from the knee joints of 43 subjects who underwent total knee arthroplasty. Visual analogue scale (VAS) pain scores were obtained prior to surgery. Customised-automated-ELISAs and commercial-ELISAs and LEGENDplex™ were used to measure soluble low-affinity nerve growth factor (LNGFR), soluble tropomyosin receptor kinase (TrkA), proNGF, β-NGF, other neurotrophins (NT) and cytokines including inflammatory marker TNF-α.
Results: The VAS score positively correlated with β-NGF (r=0.34) and there was positive association trend with neurotrophin-3 (NT-3), BDNF and negative association trend with ProNGF. sLNGFR positively correlated with VAS (r=0.33). The β-NGF/soluble TrkA ratio showed a strong positive correlation with VAS (r=0.80). In contrast, there was no correlation between pain and the β-NGF/sLNGFR ratio (r=-0.08). TNF-α positively correlated with β-NGF (r=0.83), NT-3 (r=0.66), and brain-derived neurotrophic factor (BDNF) (r=0.50) and negatively with ProNGF (r= -0.74) and positively correlated with both soluble TrkA (r=0.62), sLNGFR (r=0.26).
Conclusions: This study suggests that endogenous or cleaved sLNGFR, but not soluble TrkA may participate in OA pain modulation thus supporting further research into soluble LNGFR as a therapeutic target in OA.
Sounds significant. Phase II is typically not enough to tell if a drug is good because most drugs aren’t that effective compared to current standard of care- you need the large numbers of phase iii to see the real difference. But looks like this drug shows a marked improvement in phase ii itself so it’s actually quite impressive. Last time I read such a story was for imatinib. Expecting good things from this.
The thing with chronic pain is that often it is garbage data being sent by pain receptors. Or more accurately our muddled processing of the nerve impulses leads to poorly established thresholds that lead to a constant presence of perceived pain. So preventing this pathology based on my experience is a cure. Physical regeneration is a separate target in my opinion.
A cure for much arthritis is possibly a Nutritarian Diet promoted by Dr. Joel Fuhrman which reduces inflammation and helps the body rebuild:
https://www.drfuhrman.com/blog/119/a-progressive-approach-to...
"The traditional treatment of rheumatoid arthritis revolves around medications which typically include steroids and chemotherapeutic agents such as methotrexate, Imuran®, Gold®, Plaquenil®, Arava® and Remicade®. These medications are considerably toxic and can result in serious disability.
My approach to treating rheumatoid arthritis differs in that it incorporates dietary modifications and nutritional supplements, avoiding the use of toxic drugs in the vast majority of cases. The recommendations are customized to the needs and response of each patient to treatment and involve more than just putting them on a special diet. However, in most cases, dramatic improvements and even complete recoveries occur.
In spite of well-conducted scientific investigations and the clinical experience of many physicians, this effective nutritional treatment of autoimmune disease is generally ignored. I have seen scores of patients with rheumatoid arthritis as well as lupus, fibromyalgia and connective tissue disease obtain complete recoveries through these natural interventions. Also, I have many patients who have made complete recoveries from allergies and asthma. Not every patient obtains a complete remission, but the majority is able to avoid the use of medication."
The big problem in our current society is that there is no substantial money to be made by big companies in promoting these sorts of cures.
Methotrexate is the most vile substance (made one day per week about as useful as a full day hangover) It did help but honestly only as much as the effort I put into a diet change. I completely agree with parent comment.
Anyone with an autoimmune disorder or chronic inflammation who has not experienced an elimination diet is doing themselves a huge disservice.
> It sounds like, even in the best case scenario, the drug doesn't really cure arthritis but just blunts the pain.
> I was thinking it would be something that helps the worn ligament grow back. That I would consider a real cure.
As far as I can tell, that is what it does:
> The drug is based on a molecule he discovered while working at Pfizer, and can be delivered via a once-a-month EpiPen-style injection, where it restores protective processes to diseased joints and enables the regeneration of affected tissues. It works by blocking a compound that supports the nerve cells involved in transmitting pain signals to the brain.
This doesn't say it just blocks the pain, it says it directly affects the nerve cells involved in transmitting pain. Those nerve cells could also be responsible for other unpleasant things, like generally complaining and always being inflamed and inhibiting proper healing.
It is hoped the drug — which is not a cure but will make the condition much less painful for sufferers — could also be used to treat rheumatoid arthritis and chemotherapy-induced pain in the future.
As a writer myself who has watched journalism dying, crap articles being written by underpaid freelancers, the enshitification of the internet while everyone objects to any means used to monetize content creation, etc ad nauseum, I don't really feel like trying to figure out just how much this "really does" for patients.
The medical industry in the US tends to be about profit and I think people should, in fact, profit for their work but in medicine sometimes profit motive tosses the baby out with the bathwater. And I'm super burned out on trying to have any kind of meaningful discussion of that issue online.
"not a cure" means that if you stop taking the drug, the condition comes back, at least as far as I can tell. Which checks out given the other information given by the article.
I thought tissue degeneration was part of the issue here? Having regenerated tissue doesn't necessarily help if you stop taking the drug and the tissue just goes away again.
(It sounds weird to me that tissue can just disappear from that area so I think this might be wrong?)
If tissue gets regenerated, it shouldn't "just go away again" once you stop the drug unless perhaps there is an unidentified pathological process involved.
yeah, I too find it weird to imagine that tissue can just disappear from the inside of a joint. where would it even go? does it melt into the bloodstream or something? lmao
Interesting - this looks like Beransa[1] (Librela) which is a monthly injection for canines that have osteoarthritis. My dog did not have any noticeable changes to pain after using this for 2 months so I've decided to take him off of it.
My cat has been in the feline equivalent (Solensia/frunevetmab) for about two years, and although it had a huge positive impact for the first 12 to 18 months, it seems to have suddenly completely stopped working in the last little while.
One theory is that the immune system eventually starts attacking the monoclonal antibody med itself, another is that as in humans, the OA progression might accelerate under the drug.
I also have mine on Pentosan which did have a noticeable difference for him so that's great. You could possibly talk to your vet about this, it's significantly cheaper than Beransa (110AUD/month) and for my dog it's biannual with a booster shot in between
I actually (anecdotally) heard a similar issue with Pentosan that it stops working after 12-24 months due to the immune system so you have to "time it" at an appropriate time in a dog's life. To be blunt, by appropriate I mean you'd want to start using it 12-24 before the dog is expected to pass and not at the first sign of osteoarthritis.
where it says he took all his savings and "beat arthritis": it doesn't appear he has arthritis, he's an entrepreneur who took all his savings and founded a drug startup company with an idea he had around the time Pfizer laid him off
The title is a bit misleading, but technically correct, as in it doesn't say my arthritis. But I'm still going to take it, along with every other headline about medical (or energy) breakthrough with a biiiig grain of salt, as these are often sales pitches to attract investors.
I disagree with the critique - his JOB was / is to FIGHT arthritis on a scientific basis.
Reasoning: He does not come off as a person without sympathy, and without empathy, so I feel comfortable assuming he FEELS it when the downstream users of his discoveries achieve improvement in their life due to his "fighting" medical work.
yeah. somehow I also thought the same, but both interpretations are valid. I felt more irked by the title being in the first person when in fact the article is not written by the person seemingly making that statement
Therefore the article itself is slimy, it is overt, and you are reading it VIA a tech-blog.
The slimy idea COULD be valid if there is the belief that BECAUSE this article is linked by a tech-blog (HN), that it is a technical article. The OP, https://news.ycombinator.com/user?id=shoggouth could be the person you'd want to direct the critque at. However since the mandate of HN is not restricted to tech articles, merely interesting tech related stuff often with an entrepreneurial bent, it is appropriate.
> The drug is based on a molecule he discovered while working at Pfizer, and can be delivered via a once-a-month EpiPen-style injection, where it restores protective processes to diseased joints and enables the regeneration of affected tissues. It works by blocking a compound that supports the nerve cells involved in transmitting pain signals to the brain.
So, it restores lost tissue by numbing nerves? This makes no sense.
Wonder if it's just poor reporting or if there is something to this?
It's actually way more complicated than I think the article can explain to the audience it's targeting. Nerve Growth Factors turn a bunch of different "dials" in the body. The main ones of course are the growth, maintenance, and survival of neurons in different parts of the body however some other "dials" they adjust are inflammation and immune response.
So it affects the nerves in a much more complex way than simple numbing and on top of that it also plays a part in regulating inflammation and auto-immune activity that may worsen arthritis and prevent the body from healing what it can.
And this is a gross oversimplification but it gets the function across a bit better than the article.
The drug blocks NT-3, which is involved in nerve signaling and regeneration, but also is thought to play a role in causing the excess inflammation that leads to joint degeneration in osteoarthritis. By blocking it, it seems they believe it may allow the joints time to heal from the excess inflammation that had been causing degeneration.
The headline is misleading then, it should say "... beat the pain of osteoarthritis".
Isn't it weird how you can work on an inherently benevolent endeavour and then present the whole thing on a way that looks like you're trying to con people (and looks unscientific to boot). Marketing really is a scourge.
The drug is based on a molecule he discovered while working at Pfizer
On leaving the company, he acquired the intellectual property [IP] rights from his former employer
A lot of people don't do this when they leave or are terminated. It doesn't usually succeed, but it's always worth at least making the attempt. (In this case, Pfizer gave him the IP rights to the molecule he discovered in exchange for a portion of his company.)
One thing I learned repeatedly while dealing with a chronic health condition is to never assume that you're "about to beat it". I've had that feeling about 1000 times now, and telling that to my family and friends just made me sound like an idiot, since I would invariably regress again.
Now I'm at a point I would only be fine with saying this if I didn't have any issues after a prolonged interval.
This article is about a biotech company that is aiming to reduce pain from arthritis using an injectable chemical (as an alternative to taking ibuprofen every day), whereas I think from your comment it sounds like a personal journey hoping to recover from a chronic health condition (I doubt this is happening any time soon for arthritis, unfortunately).
Some do see remission with the modern expensive Biologics, but those only treat the underlying inflammatory condition. The damage to a body remains from the inflammatory cycles, short-term steroid treatments, and pain medications.
It is one of my biggest pet peeves seeing folks with "good intentions" spout off about nonsense "cures" for a suite of currently chronic conditions. There are specific gene therapies being researched that _may_ remove the need for heavy medications at _some_point_ in the next decade, but the damage done by the disease will still require joint replacement surgeries etc.
Most competent people I've met have zero sense of humor when it comes to this area of research, and would have also fired anyone that mistakes pain medication for a "cure" (unless I misunderstood the press release gibberish.)
Have a great day, and please consider starting a fact-checking wiki like snopes to document the ignorant new age nonsense people perpetuate. =3
Your gut health has a direct impact on your lower back. If you are intolerant of some foods, when you inflame your gut, your lower back can end up in pain as well.
I'm intolerant of a milk protein. I can handle the bathroom consequences, I can't handle the lower back consequences.
Interesting. I’m starting to suspect dairy. I just tried switching to a2 milk but didn’t notice a difference. Have you tried a2 milk with the a2 casein protein?
I have not. I'm rarely in a country where that is available. Usually when I'm in the states, I'm not willing to experiment with it on my one week visit.
Foods that decrease inflammation _probably_ help with arthritis; processed foods _generally_ increase inflammation, which is probably why you feel better not eating them.
There is also nutritionfacts, which takes a science and clinical study based approach to look at how diet plays a role in a whole host of diseases and conditions: https://nutritionfacts.org/?s=arthritis
* nutritionfacts and Dr. Greger do have several vocal opponents however, so I encourage you to read the studies themselves and come to your own conclusions
I have a sero-negative inflammatory arthritis. The only thing that makes it better is meloxicam; that shit is AMAZINGLY effective, completely makes my symptoms go away for 2-3 days if I take the full 15mg. Unfortunately due to the risk of stomach bleeding and my sensitive stomach, I only take 7.5mg every now and then and only 15mg when I really need to do something active (walk long distances). Note: I tried celecoxib and it did nothing, but some people have luck with it over meloxicam.
Now there are foods that make it worse: generally anything with high sodium like pizza, fries, fast-food/restaurant food (Chinese food especially). Caffeine also makes it slightly worse. By far the worst of them all is alcohol though. After the alcohol wears off, I'm in so much agony that I can barely walk.
If a family farm couldn't produce it themselves I try to avoid it. I think this works pretty well as a rule of thumb (and justifies me stilling having beer and wine lol)
Processed foods usually refers to packaged snacks, food with lots of added ingredients, corn oils, artificial ingredients, etc or fast food/junk food ordered at restaurants/fast-casual places.
I’m 44. Interesting idea. My pain is top of the back hips. But could be. It doesn’t sound like it’s treated any differently than arthritis or random joint pain? Is it worth getting diagnosed?
> It doesn’t sound like it’s treated any differently than arthritis or random joint pain?
I'm not an expert but I think there are specific treatments depending on the cause.
> Is it worth getting diagnosed?
I guess that's a balance against the time and money it will cost you to get a diagnosis vs the benefit. Where I live, cost would be about 3-5 hours and $300-1000 in consultations, blood tests and scans if you're not insured.
Benefits are: being able to halt ongoing joint degradation, preventing or quickly reacting to more impactful flare-ups, making better long-term choices in exercise, diet etc.
Tangential question: as I now start suffering from arthritis in my hands, I was wondering if there is anything linked to diet that could help reduce it?
I had read that fatty fishes were a good source to reduce pain but in your experience, is there any other food/lifestyle changes that can help alleviate it before resorting to medication?
Arthritis is an auto-immune disorder, and while this might sound “basic” I would see what a high dose of vitamin D supplement can do for you, with preliminary blood work and a doctor’s approval of course. Vitamin D is very important in immune system regulation.
It has helped my mom who’s 74 (and has had it since early 50’s) significantly to the point where pain is mostly gone and inflammation is rare. It took about half a year for symptoms to be mostly gone. While it was my idea her doctor signed off on high dose (6000% typical daily allowance) prescription supplements considering the practically non-existing risk. Two years on and it’s stable and her life is a lot better.
You’re correct, I forgot to specify: my mom has both, but her osteoarthritis has practically been “paused” for two years after getting the rheumatoid arthritis in check. Her specialist is not sure why that is. And this is years after she stopped to southern climates during the winter months which used to be her only relief and help. They’re doing regular check ups to keep it observed.
I know this is a lil more extreme and Dr Greger does have an agenda of Plant based diets but he always has a decent explanation of the possible triggers.
I know this is well-intentioned, but please keep this stuff out of health threads about serious health conditions. This kind of material lacks rigor, dramatically misrepresents the state of scientific and medical thought, cherry picks studies, overstates the effect sizes and passes off speculation and easily digestible explanations (for laypeople) as emerging medical truths.
Long-term sufferers of RA - and the people in their support networks - know first-hand that RA is a complex and progressive condition that requires some pretty hardcore medical interventions to manage. Like other auto-immune diseases, different people will experience different disease courses. A very small few will be lucky enough that their disease goes into remission for no clear reason. Others will try everything under the sun only to see their disease become worse and worse. The reality for sufferers is that there aren't quick fixes and simple triggers.
It's reasonable to expect that general lifestyle interventions such as healthier diet and the right type of exercise regime may improve symptoms within the margins permitted by the underlying disease process. But promoting content that centers the role of "lifestyle" once RA has already developed only trivializes the disease and widens the empathy gap that sufferers already face.
Dietary advice is one thing. Woo peddling and fringe medicine is another. The original question didn't even ask about rheumatoid arthritis.
I'm not overreacting. There are many people who will read my comment and know exactly what I'm talking about. This is simply a "you get it or you don't" situation where you're currently on the "doesn't get it" side.
I have psoriasis and psoriatic arthritis which I take biologics for. The biologic I am on now is working wonders but the others have been hit or miss.
In my experience, removing sugar has helped. Tumeric and Glucosamine have been known to help with anti inflammatory ailments. My sister in law takes bone broth and it has helped a lot with issues.
Does stress play a role in flare-ups for you? A family member has this, and aside from joint shocks .. kicking a thing too hard resulting in knee flare ups .. his stress level impacts his flare ups. E.g. "This thing in my life is going badly and I cannot escape it." .. when he does escape it, there are fewer flare-ups. ?
Eat foods in a way that can ignite ketosis periodically throughout the month and treat carbs as it's something your allergic to. I have personally (finally after 7 years) started regulating my cluster headaches which is an inflammation problem.
I think you're right. I suspect pre-diabetes causes lots of these types of symptoms especially when you're not young anymore, and basically the cure is manage carbs (and exercise)
If I was in your position, I would ease in to a whole food, plant based diet.
What this means is a lot of cooking from scratch, which means hands! So how about a whole food, plant based diet that requires very little preparation?
This is serious, so please do not waste time with 'cut out teh carbz' bro science. Do not take advice from anyone that talks of 'seed oils' and other keto talking points. Keto and carnivore diets are fad diets that are just another way to get to calorie restriction. They are popular amongst people with protein obsessions and social media influencers, because who does not want to eat steak and butter?
The whole food, plant based diet means no animal products, no refined sugars, no processed foods and lots of plants. Lots is important as vegetables, pulses, grains, beans and fruit are not as calorie dense as a lump of meat. You will need to be eating huge bowls of cooked food and not skipping meals just so you can get your calories in.
On a whole food, plant based diet, you can vary your diet by the season. This means buying from the vegetable and fruit aisles, going for whatever is on offer.
Due to the hands, you might want to buy lots of prepared frozen vegetables. Get the lot.
Oils are what you don't want in your system. Clearly we need some fats but there are plenty in nuts. Personally I only use a small amount of mild olive oil in the air fryer, I don't have butter or fake spreads.
Sugar is surprisingly easy to give up and comes with immediate health benefits as you have to home cook everything to avoid sugar. Sugar is in sauces and other savoury products that you would not expect.
Once you have knocked off sugar, you can knock off the animal products and expand your repertoire of goto plant based recipes.
What works for me is slow cooking. I usually start by putting a chopped onion and some garlic in the pot, to then add some starchy vegetables such as sweet potato, then some leafy greens, then a tonne of lentils and dried beans.
If there is room I put even more vegetables in and add some herbs and spices. Sometimes this could be a curry, or it could be a new herb I am experimenting with. Ginger goes in quite often, there is no fixed recipe as recipes are boring.
I usually add some chopped tomatoes, top up with water and set the thing to do its thing for about four hours.
This approach means I am spending twenty minutes in the kitchen every day, in total. I often add grains such as rice or barley, or I add pasta to the pot after taking my first portion, adding water as appropriate. Grains or pasta does not take four hours, an hour should be good. This means my second portion is a variation on the first.
To top out my slow cooked creation I put some tofu or even some vegetables such as broccoli in the air fryer, with some herbs. This gives different texture.
Just by varying the ingredients I can get variety even though I am doing a one pot meal.
Be an autodidact with this, implement your changes on a monthly basis and see how the inflammation in your hands changes. If you go WFPB then you should end up with excellent gut health, to be in the middle of the Bristol Poo Scale every time, with farts that don't smell.
This is an elimination diet, specifically sugar and animal products. Once you have done the 'factory reset' then you can add in the favourites again, super sensitive to how you feel afterwards. Or you might not want to. I could not care for sugar when it was gone, and the same with dairy, which I thought I was wedded to.
One pot meals, tray bakes and air fried things provide enough variety for me. I don't indulge in salads because of the lack of calories, and neither do I make smoothies because they are for babies, gym bros and people in care homes. Cooking is our original innovation and we need cooked food, mostly starches, to get the calories in.
> Keto and carnivore diets are fad diets that are just another way to get to calorie restriction
I wouldn't be so confident in publicly discouraging my fellow human beings from trying these diets.
Speaking personally, I tried various diets -- raw milk diet (drinking 4L of raw milk a day), vegan diet, fruitarian diet, keto diet, caloric restriction, etc. -- before discovering that the carnivore diet helped my own condition (induced by antibiotic abuse), and I wrote about it here: https://srid.ca/carnivore-diet
Diets are personal; people should experiment and find out for themselves. In the long term, therapies like FMT should become widely available, enabling many of us to eat a wider range of food stuff.
For some reason we have been dragging around this lower intestine that, if keto/carnivore fans would have you believe, we do not need. And that is true, there are people with colostomy bags that are high achievers, without having a functional lower intestine.
Yet others believe that you should be eating all of these fancy probiotic and prebiotic foods to maintain 'gut health' of this lower intestine, as if your life depended on it.
Assuming that both a keto/carnivore diet and a WFPB diet eliminated the food that was causing inflammation, let's say it was sugar, to relieve the arthritis flare ups, then you would think that it would not matter which solution was chosen by the OP.
Well no. The WHO do not list carrots, potatoes and tomatoes as carcinogens. They are not so kind on meat products though. Or alcohol, for that matter. In my own situation, I have a heavy meat eating relative that is having another part of his digestive tract or waterworks operated on every year to remove cancer. He insists on all of the tests, PSA etc., however, I am not willing to just eat steak and get drunk every evening, dutifully getting my nether regions screened for cancer. He would have me believe that it is genetic and not to do with consuming carcinogens. I beg to differ. He has eliminated fibre from his diet, I have eliminated carcinogens.
Fundamentally, our digestive tract is not that of a true carnivore, and, even if it was, there is a price to be paid for consuming animal fats and proteins. This is in the arteries. They get clogged, leading to strokes, heart disease and much else, including cancer, according to some. True carnivores don't live that long, compare the lifespan of the lion to that of its prey. This does not matter to them as they only need to get to reproductive age and procreate.
After getting past the procreation age, priorities change at the individual level. I don't want to die of a heart attack in my fifties, sixties, seventies, eighties or nineties. There are two options for solving this problem, my relative with the cancer woes, steak in one hand, beer in the other, takes a smorgasbord of pills ranging from blood thinners, to statins to much else. He has had the heart bypass operations and more stents than I can count.
Me, I see prevention as better than cure, so that means maintaining a BMI between 19 and 20 with optimal blood pressure, with no cause for blocked arteries due to a diet free of animal products combined with active travel (cycling rather than car dependency).
My relative sees this as no fun at all. Yes, diets are personal. He sees a good weekend as down the pub eating steak and drinking beer, with good company. You can't argue with that, particularly if you are in your twenties. But, I don't want that to be the only option open to me. I like to be able to cycle near effortlessly, to go places and do things during the weekend, even if the only company I get on the way is at the acquaintance level.
Each to their own, I get it. But I am not advocating anything weird. Raw milk, keto, fruitarian, carnivore, junk food vegan and plenty of other diets are weird. You need to be secretly wanting to be in a cult to sign up to these things. No processed food, no refined sugar, no animal products and no alcohol is not how I lived in my younger years, but the fate of my relatives and ancestors has made me embrace the WFPB diet.
Enjoyed reading your post about your success with a WFPB diet as well as the followup comment. Thanks for posting them! Liked your dynamic slow cooker approach to variations. I should try that.
Sad to see your informative and insightful comment modded down. Just goes to show how problematical discussion of all this can be. The issue is not so much ignorance as decades of (often profit-driven) misinformation. Peter C Gøtzsche wrote some books on problematical issues with a profit-driven medical industry.
Some more comments on related issues -- pardon if you have seen much of this before.
On your last paragraph, for salads, Dr. Joel Fuhrman suggests "Make the salad the main dish" including by adding a lot of things to it, like chickpeas and so on, and making dressing using nut butters.
https://info.drfuhrman.com/make-salad-the-main-dish
He's also big on smoothies, especially in the morning, where people can drink them on the go.
As a rule of thumb, Dr. Fuhrman basically suggests eating one pound raw foods and one pound cooked foods per day (ideally all WFPB). I can't say I manage that though. I keep trying to take short-cuts to all this, and probably none of them work that well. I've also tried meal delivery services (like Whole Harvest) but the cost, packaging, timing, and not having recipes tuned to my tastes is problematical -- even if the food is generally healthy otherwise. I am at least eating a lot more leafy greens, often in wraps -- although what I use for wraps can be problematical (any of processed wheat wraps, Ezekiel wraps, corn tortilla wraps, Nori wraps, large leaf lettuce, some worse than others).
Right now I am struggling with what to eat for breakfast. I have been trying some organic oat-based cereal with almond milk, fruit, and an organic plant-based protein powder -- but I know it could probably be much better if I was cooking more. Related to that I have been doing roughly 8:16 intermittent fasting by shifting my eating window into the mornings from roughly about 8am to 4pm (after a seven day water-only fast a couple months ago). So a good breakfast becomes more important. Surprised no comments by anyone here so far have mentioned fasting as another possible way to help with arthritis and other autoimmune issues.
The book "The Pleasure Trap" explains why so many people (whether me or your relative mentioned in your followup) are caught up in a "Pleasure Trap" of unhealthy eating related to how our natural inclinations rooted in food scarcity are maladapted for a world of food abundance (especially an abundance of salt, sugar and fat found in engineered ultraprocessed foods -- and also various non-food-related stress where the natural human response to stress is to fatten up for likely hard times):
Joe Cross' movie "Fat, Sick and Nearly Dead 2" explores why it can be so hard to keep up with healthy eating in modern Western society:
https://www.rebootwithjoe.com/watch-here/
From:
https://www.rebootwithjoe.com/about-fat-sick-nearly-dead-2/
"But then a funny thing happened, even with all the knowledge I’d learned, the techniques and tips I’ve gotten from experts, the fact that I was still off all of my medication, I found it was an ongoing struggle to keep the weight off! I was like, “hey, this isn’t supposed to be happening!” I’d done all the hard work, I even got off my meds! But that’s not how it works. I learned that losing the weight was easy, that the hard work really starts when you’re trying to maintain the weight loss. I quickly realized that I wasn’t alone. Seems like everyone has trouble keeping the weight off. That’s where the idea for “Fat, Sick & Nearly Dead #2” came from. I figured that I might as well share all this stuff. I was learning? So while I traveled to 10 countries, learning about health and nutrition along the way, I brought along the camera crew and what I found out is what you’ll see in the film. I visited doctors like Dean Ornish who gave me insight into the keys to health besides food, and Sheila Kar who gave me a view of my own arteries. A real eye-opener, I’ll tell you! I also wanted to know the power of marketing and see if I could eat only what I wanted to, not what I was being told to eat. That was what led me to Professor Brian Wansink who took me on a very enlightening tour of his hometown and showed me how food is sold to us and what we can do about it."
One interesting thing I read on Dr. Fuhrman's site somewhere is that one patient concluded it was cheaper to spend a month at a retreat and learn to eat better to reverse his heart disease than it would be to pay the deductible and copays on a heart bypass operation. I can wish there were more such health retreats all over the USA and the world -- maybe a Y-Combinator success yet to happen about that someday?
https://www.drfuhrman.com/etlretreat
Supper clubs are one alternative to "retreats":
"Logical Miracles: 100 Stories of Hope and Healing"
https://www.amazon.com/Logical-Miracles-Stories-Hope-Healing...
"Why is it so hard to eat right? What does it take to turn around the habits that make us sick and fat? Logical Miracles is a collection of stories by people in The Suppers Programs who found their personal solutions by experimenting with whole food. In an environment of nonjudgment, we cook, taste, and feel our way to health, and we forge new friendships based on healthy living. For five years, pilot Suppers groups have been helping people with a range of food-related challenges find their path, especially people with depression, anxiety, learning issues, obesity, diabetes, and problems with alcohol. No special diets. No fees. No commercial messages. The only requirement for membership is the desire to lead a healthier life. Now we’d like to share our logical miracles, our road maps, our recipes, and especially our hard-earned wisdom related as stories of hope and healing. Welcome to Suppers."
A bigger societal-level approach to transformation towards health is pursued by the "Blue Zones" project.
https://www.bluezones.com/
Congrats on finding things that work for you to stay healthy in our current short-term-profit-maximizing society -- one that often privatizes gains like from addictive ultra-processed foods while socializing costs like ill health (paid for by higher medical-related taxes/borrowing and higher "health"-insurance premiums, not to mention years of personal suffering or family/communal grief from early deaths).
Yeah, it doesn't seem to explain how doing something about the pain receptors is actually fixing the issue; it improves quality of life, sure, but does it fix the cause and repair or avoid damage?
That is, if it's only suppressing pain, the people suffering will do more things that may cause more cartilege damage. (disclaimer: I don't know much about arthritis so I may be wrong)
Until I started doing things to help my knees, the stuff I was doing, that I covered with NSAIDs actively made things worse.
I’ve had osteoarthritis in my knees since I was 16. At 27 I was opened up and told I had worn grooves through the cartilage and into the bone (I guess that’s why it hurt to ride a bike).
Doc told me quite literally to sit on a couch. Instead I took up karate, and the enforced stretching there relieved a ton of the pain. It didn’t fix anything, and i’d still get knee pain when riding a bike (I cut way back) or running, but my every day experience was tolerable.
In the past few years I started going to a functional fitness gym, and our coach got me towing a sled backwards- THAT fixed up my knees. Something about it has let my knees repair, and I haven’t had knees that felt this good sinc3 at least 1990.
been on an elimination diet for a while, because if I'm not, I get depression and suicidal ideation.
I don't have a diagnosis for arthritis, but I'm testing around a lot and maybe this info helps you in your journey:
I make gelatine from pig's feet occasionally, when I make it with just salt and some lemon or vinegar, I don't have problems.
Last time I thought, maybe try bell pepper, haven't tried for a while and I seem to do okay with capsaicin. Boy was I wrong, within a week I got horrible joint pain in the feet.
Bell peppers are seemingly high in lectin and other phyto-nutrients.
I recently found on hacker news, that I can neutralize oxolates with a pro-biotic - will try that for lectins next. Have to prepare the gut with L-Glutamine and Silicea.
God's speed!
Edit: Between ingestion and symptoms, it takes about 3-4 days
It's orthogonal to the diet, I actually force myself to eat normally including eating carbs, I actually take it specifically only because it has a strong positive effect on my immune system. There's some research showing as much.
makes sense to me unless you get autoimmune symptoms from them, to me it means that something gets through the gut-lining that shouldn't - I get depression from carbs, been looking for a solution since 2018, seen many doctors throughout the years.
Anecdote: I have reactive arthritis comorbid with ulcerative colitis. I was getting debilitating arthritis flares once a month until I stopped eating gluten, peanuts, and added sugar. I haven't had an arthritis flare since eliminating these foods.
My rheumatologist wanted to put me on methotrexate but I declined out of fear if the side effects. He never mentioned anything about diet, but clearly a dietary intervention worked for me.
Many times, I met people who genuinely believed they were super close and about to achieve a "huge" breakthrough.
In each case, the scientists themselves, in their minds, were absolutely convinced they were on the brink of unfathomable achievements: curing Alzheimers, or some cancers etc.
Particularly true for the scientists in biomedical startups - they were like Mulder from X-Files; they all wanted (and were desperately eager) to believe. Like Elizabeth Holmes of Theranos, I think she completely believed her own exaggerations and BS - at some point, fact and fiction merge.
Thus I've become extraordinarily skeptical of articles like these.
My cat has the occasional bad arthritis flare up which we give her Solensia (another NGF targeting drug, but via monoclonal antibodies) for. It works incredibly well. Within 12 hours they go from being barely able to walk to being totally fine and mobile again.
If a lot of money is on the table, all kinds of loopholes can exist. You see stuff like that, all the time, with academic research.
[EDITED TO ADD]
It’s really common for large corporations, with staff counsel, to lodge lawsuits they know they can’t win, because they bet their pockets are deeper, and they think they can force a settlement.
Ugly, but it’s the American way. He may have more luck in the UK, though.
This is a common deal in this industry, and the terms are fairly standardized. They get a small stake, and usually something like follow-on rights, sometimes more. In this case, Pfizer invested further after that. The big drug companies have a very large stake in making sure departing employees aren't scared of taking this particular deal because they write off a ton of drugs this way, and the only way to profitability on that IP is if someone takes the IP and takes the vast majority of the risk and cost, as this guy has. Don't think I've ever heard of an instance where someone took this deal and got screwed by doing so -- only instances where someone didn't (or tried to weasel out of the deal) and then ended up screwed.
Yes, I asked again after you tried to derail the conversation away from why paywalled content is allowed. It's also bizzare you've taken to stalking my comments over it too that are over a week old.
The timeline is that you replied 4 days ago to the original thread, then 3 days later continue to try enage in arguments with me in another thread. Did you spend those three days festeringly mad and couldn't help but go in for round three?
If I made sure every paywalled link posted here had a paywall workaround linked in the comments, would that make you more mad? The FAQ says those links are allowed, but what are your personal feelings on it?
"it restores protective processes to diseased joints and enables the regeneration of affected tissues. It works by blocking a compound that supports the nerve cells involved in transmitting pain signals to the brain."
Yes, I guess you could belittle that by calling it 'a painkiller'. No different at all to taking a handful of ibuprofen, which every arthritis sufferer knows enables regeneration and why it is a solved problem.
This is true, although it looks like in this case it may be more useful than just another pain killer, in that if you can reduce the joint pain, people might be more active, which may help them lose weight, which may reduce joint pain. If it's safe to take long term (reading between the lines, sounds like it might be compared to other pain killers), then it could have lasting impact on patients beyond them taking it, which is a good thing.
this is for OA, which means people dont have much joint left in the first place. That is what causes pain. not feeling pain will not turn them into marathon runners
> The drug is based on a molecule he discovered while working at Pfizer, and can be delivered via a once-a-month EpiPen-style injection, where it restores protective processes to diseased joints and enables the regeneration of affected tissues. It works by blocking a compound that supports the nerve cells involved in transmitting pain signals to the brain.
The mechanism might be to affect the nerve cells involved in pain signaling, but the effect is to actually help regenerate tissue.
This needs some heavy scrutiny, it seems like this is related to tanezumab. Which yes, blocks pain by affectively sticking a lego in front of another lego that when connected says hey I'm hurt, but doesn't pro-actively heal anything as far as I'm aware.
The usual play with claims like this is that with reduced inflammation there might be a better chance of circulation allowing for better natural regeneration (somewhat true?). But active regeneration of damaged tissue especially in places typically afflicted with athritis is a bit more complex because it's often at osteochondral boundry layers aren't as vascularized.
As a youngish sufferer of osteoarthritis in my foot I had my hopes up, however there is no mention of cartilage or bone in the article.
The “cure” for osteoarthritis would need to regenerate or replace damaged or missing cartilage, a seemingly impossible task from my limited understanding.
Two patients can have identical knee x-rays/MRIs - loss of joint space and osteophyte formation etc. But one has pain and the other does not. Do they both have osteoarthritis? They clearly don't have the same dis-ease.
Patient don't care about having cartilage or bone sclerosis or subchondral cyst formation; they care about pain that stops them moving (which in turn can increase their weight further exacerbating the joint issues).
So, osteoarthritis is a problem in that it causes pain. If something specifically reduces osteoarthritic pain, I am okay with it saying it 'beats' the dis-ease.
The issue that people have here is whether being a pain-killer merely masks the disease temporarily and leads to people ignoring the problem and hence aggravating the disease even more. Pain is usually a signal of a real and valid problem.
I am merely explaining what the issue at hand is - I am not saying that is what the proposed medicine does. Another way to say it, is the compound treating the symptom or the problem - or perhaps both.
Imagine you have a hernia that hurts and you take medicine that masks that pain, do you still have hernia?
Strong disagreement, and I think if you'd spoken with any serious arthritis sufferers who are desperate for literally anything, you'd realize how incorrect you are.
Anyone who takes a drug every day has had this thought and quickly moved past this narrow point of view.
We all want to live long, healthy lives, and whether we like to admit it or not, the human body isn't built to match our modern expectations for longevity. If you plan to live a long and comfortable life, taking multiple drugs every day is in your future. For some of us it comes sooner than it does for others.
> Nearly nine in ten (89%) adults 65 and older report they are currently taking any prescription medicine. This compares to three-fourths of 50-64 year olds who report taking prescription drugs, half (51%) of 30-49 year olds, and four in ten (38%) 18-29 year olds.
This is revolutionary!! truly exciting stuff, I wish I read more about these sorts of breakthroughs monthly....I hope we'll get to this level more regularly with AI biology models.
but the sentence prior says "it restores protective processes to diseased joints and enables the regeneration of affected tissues." I don't understand how it does if it's just blocking pain signals.
I don’t know about this case, but in general, the body’s reaction to pain sometimes makes things worse, so relieving pain can be part of encouraging recovery.
This is at best a fallacy with occasional exceptions and in this particular case, just plain incorrect.
If it works by 'blocking a compound that supports nerve cells in transmitting pain' it isn't doing anything to correct the pathology. You are, in the truest sense of the way that people naively talk in derogatory terms around modern medicine, 'treating the result, not the cause'
It's definitely not a fallacy that things that relieve pain can also help heal or prevent damage, NSAIDs are a great example. It mentions it may do more than just blocking the signal in the article.
Headline seems a bit overdone. The drug completed Phase 1 trials. Roughly 14% of successful P1 trials eventually get approved. It'll be probably another 5-10 years before this finishes P3.
Not sure what article you read. Phase II trials just wrapped up and showed both tolerability and effectiveness, hitting primary endpoints. Phase III is apparently recruiting, which should reveal any showstopper side effects in a larger and more diverse population. It’s realistic this could hit the market in 3-5 years or less.
It completed Phase 2 trials according to the article. I don't know the rates of P2 trials getting to approval, but he's past safety and initial efficacy in over 510 patients (510 seems to have been only the last trial, so doesn't include P1, which would be significantly smaller).
> The drug is based on a molecule he discovered while working at Pfizer.
Is Pharma different than Engineering in terms of IP?
If my former employer has evidence that what I am working on in a new gig was discovered while on company time using company resources couldn't they sue?
It says he used the money from redundancy to continue with his work. Pfizer would have a hard time winning that case because the discovery was made past their employment. Having field knowledge doesn't make it a crime. Coding is different because it's easier to copy paste functions & classes, it also doesn't help that everything has timestamps. Your best bet is to rewrite everything.
Maybe it's semantics, but I understand it was discovered while at Pfizer and further developed post-redundancy. IANAL but it definitely feels like a grey area?
It's not a grey area at all. The article literally says that he purchased the IP rights from Pfizer, and as part of the deal they got a small stake in his new company.
This is the only publication I found in a quick search:
https://pubmed.ncbi.nlm.nih.gov/37976118/
>> Abstract
Objectives: Nerve growth factor β (β-NGF) is a protein which is important to the development of neurons particularly those involved in the transmission of pain and is central to the experience of pain in osteoarthritis (OA). Direct NGF antagonism has been shown to reduce OA pain but is associated with rapidly progressive OA. The aim of the study is to investigate the ability of soluble neurotrophin receptors in the NGF pathway to modulate pain in OA.
Methods: Synovial fluid (SF) was obtained from the knee joints of 43 subjects who underwent total knee arthroplasty. Visual analogue scale (VAS) pain scores were obtained prior to surgery. Customised-automated-ELISAs and commercial-ELISAs and LEGENDplex™ were used to measure soluble low-affinity nerve growth factor (LNGFR), soluble tropomyosin receptor kinase (TrkA), proNGF, β-NGF, other neurotrophins (NT) and cytokines including inflammatory marker TNF-α.
Results: The VAS score positively correlated with β-NGF (r=0.34) and there was positive association trend with neurotrophin-3 (NT-3), BDNF and negative association trend with ProNGF. sLNGFR positively correlated with VAS (r=0.33). The β-NGF/soluble TrkA ratio showed a strong positive correlation with VAS (r=0.80). In contrast, there was no correlation between pain and the β-NGF/sLNGFR ratio (r=-0.08). TNF-α positively correlated with β-NGF (r=0.83), NT-3 (r=0.66), and brain-derived neurotrophic factor (BDNF) (r=0.50) and negatively with ProNGF (r= -0.74) and positively correlated with both soluble TrkA (r=0.62), sLNGFR (r=0.26).
Conclusions: This study suggests that endogenous or cleaved sLNGFR, but not soluble TrkA may participate in OA pain modulation thus supporting further research into soluble LNGFR as a therapeutic target in OA.