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Hyperbaric therapy in MS

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Here's the info on hyperbaric therapy in MS. There are a couple of

studies which show benefit, but mostly no benefit.

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Author

M. Heard R.

Institution

Diving and Hyperbaric Medicine, Prince of Wales Hospital, Barker St,

Randwick, NSW, Australia.

Title

Hyperbaric oxygen therapy for multiple sclerosis. [Review] [39 refs]

Source

Cochrane Database of Systematic Reviews.(1):CD003057, 2004.

Abstract

BACKGROUND: Multiple Sclerosis (MS) is a chronic, recurrent and

progressive illness with no cure. On the basis of speculative

pathophysiology, it has been suggested that Hyperbaric Oxygen

Therapy (HBOT) may slow or reverse the progress of the disease.

OBJECTIVES: The object of this review was to evaluate the efficacy

and safety of HBOT in the treatment of MS. SEARCH STRATEGY: We

searched the Cochrane MS Group trials register (July 2002), the

Cochrane Central Register of Controlled Trials (The Cochrane

Library, Issue 2, 2002), MEDLINE (January 1966 to October 2002) and

the National Library of Medicine (NLM) database (July 2002), along

with specialised hyperbaric resources and handsearching of relevant

journals and proceedings. SELECTION CRITERIA: All randomised,

controlled trials involving a comparison between HBOT and a sham

therapy in MS were evaluated. DATA COLLECTION AND ANALYSIS: Two

reviewers independently appraised all comparative trials identified,

extracted data and scored them for methodological quality. MAIN

RESULTS: We identified ten reports of nine trials that satisfied

selection criteria (504 participants in total). Two trials produced

generally positive results, while the remaining seven reported

generally no evidence of a treatment effect. None of our three a

priori subgroup analyses placed these two trials in the same group

and were therefore unable to account for this difference. Three

analyses (of 21) did indicate some benefit. For example, the mean

Expanded Disability Status Scale (EDSS) at 12 months was improved in

the HBOT group (group mean reduction in EDSS compared to sham -0.85

of a point, 95% confidence interval -1.28 to -0.42, P = 0.0001).

Only the two generally positive trials reported on this outcome at

this time (16% of the total participants in this review). REVIEWER'S

CONCLUSIONS: We found no consistent evidence to confirm a beneficial

effect of hyperbaric oxygen therapy for the treatment of multiple

sclerosis and do not believe routine use is justified. The small

number of analyses suggestive of benefit are isolated, difficult to

ascribe with biological plausibility and would need to be confirmed

in future well-designed trials. Such trials are not, in our view,

justified by this review.

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