Parkinson's Disease Tulip


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Old 08-16-2007, 09:55 AM #1
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Default Spheramine presentation

Hi,

Dr. Elke Reissig from BayerSchering AG will provide a presentation on the 1st World Congress on Controversies in Neurology to be held 6-9 September in Berlin.
http://www.comtecmed.com/cony/

Title of the presentation: Spheramine cell therapy.
As all patients of the phase IIb study in the meantime got the surgery maybe we will get some preliminary results whether the positive results from the phase I study will be confirmed and as a result this approach can provide a promising alterantive for all people suffering advanced PD.

Information regarding the risks and the safety profile would also be helpful.

frank
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Old 08-17-2007, 08:52 AM #2
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Default Thanks Peter ...

you at least seem to be one of the guys who remembers there is a human element to drug research as well as a "pump and dump" perspective.

Why not share your conversations with Titan/Bayer Investor Relations staff, as you know Spheramine is a hot topic here.

Good luck to "Titan longs", you win we all win.

Neil.
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Old 08-17-2007, 10:10 AM #3
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Neil,

of course I would like to share information.
I am in regular contact with Schering and they told me that the immediate risk of surgery is thought to be the same as for deep brain stimulation, but the cumulative risk, including that caused by hardware remaining
in the brain and repeated surgery in the case of electric stimulator implantation, may be lower.

Preliminary safety results from the ongoing double-blind, placebo-controlled
(STEPS) study in 68 patients are encouraging, while efficacy data from this trial will be presented later.

Promising efficacy results from a pilot study in six patients followed over more than 36 months have been observed with no safety complications.

Will keep you informed.

frank
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Old 08-19-2007, 12:23 PM #4
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Default Spheramine

My mother was one of the phase IIb study participants. At the time of enrollment, she was scoring 89-90% on the activities of daily living scale while medicated. Within months after Spheramine she went into a nursing home unable to walk, bath, dress, toilet or feed herself. She was one of 2 patients enrolled through UCLA. The other patient died.

She suffers from hallucinations and has to be restrained because of them.
My mother has spent almost 2 years in a nursing home, in the dementia ward, in restraints due to spheramine and yet is aware of her situation. I wouldn't wish that experience on any living soul.

The records attribute her decline and hallucinations as certainly due to the procedure and probably due to the spheramine.

The informed consent states if you are injured care will be provided at no cost to you. This is not the case. To date none of the cost of care has been paid.
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Old 08-19-2007, 05:07 PM #5
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jilanguille,

If you would like to discuss what happened in your mother's trial would you please send me a private message? Was this ever made public?

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Old 08-19-2007, 05:36 PM #6
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Quote:
Originally Posted by jilanguille View Post
My mother was one of the phase IIb study participants. At the time of enrollment, she was scoring 89-90% on the activities of daily living scale while medicated. Within months after Spheramine she went into a nursing home unable to walk, bath, dress, toilet or feed herself. She was one of 2 patients enrolled through UCLA. The other patient died.

She suffers from hallucinations and has to be restrained because of them.
My mother has spent almost 2 years in a nursing home, in the dementia ward, in restraints due to spheramine and yet is aware of her situation. I wouldn't wish that experience on any living soul.

The records attribute her decline and hallucinations as certainly due to the procedure and probably due to the spheramine.

The informed consent states if you are injured care will be provided at no cost to you. This is not the case. To date none of the cost of care has been paid.
jllanguille --

I am so sorry - this is terrible. I was confused because I knew that there is a Spheramine phase IIb trial that has just finished recuriting in the past month or so. I did not know there was an earlier phase II trial - which had begun in 2002.

I'm assuming it was in this study (below) that your mother was in? And also BobT - whose post from a different thread I have included as well.

Why aren't we hearing more about this?

Jean


2002 phase II spheramine study:

TITAN LAUNCHES RANDOMIZED STUDY OF
SPHERAMINEÒ IN PARKINSON’S DISEASE


South San Francisco, CA – December 19, 2002 – Titan Pharmaceuticals, Inc. (ASE:TTP) today announced that it has initiated a multicenter, randomized, blinded, controlled study of SpheramineÒ in Parkinson’s disease. The newly launched Phase II clinical study will enroll 68 patients with later-stage Parkinson’s disease (Hoehn and Yahr Stages III and IV) to further evaluate the efficacy, safety, and tolerability of Spheramine, a novel cell therapy under development by Titan and Schering AG, Germany (FSE:SCH, NYSE:SHR), Titan’s corporate partner for worldwide development and commercialization of Spheramine. Schering AG, Germany is fully funding the clinical development program of Spheramine.


Spheramine is a unique cell therapy product utilizing normal human cells attached to microcarriers that enable long-term survival and function of the cells. The particular cells used, called retinal pigment epithelial cells or RPE cells, produce L-DOPA and directly enhance brain levels of dopamine, a neurotransmitter that is deficient in certain brain regions in Parkinson’s patients, leading to movement disorders. RPE cells can be grown in large numbers using cell culture manufacturing methods to produce many thousands of doses of Spheramine from a single starting tissue sample. Spheramine is injected into the brain regions lacking dopamine, using a surgical technique called stereotactic injection, which does not require general anesthesia.



Quote:
Originally Posted by BobT View Post
i am a spheramine patient. While results are not complete periodic updates are sent to FDA. At the time of my surgery the results of 55 had been reported with 13 still in process. According to my documents dated August 2006, the first surgery was April 2003, the last June 2007.
Attached is results of 55 in phase 2 directly from my consent form
What follows is only 2 of 17 pages related to spheramine. whie you may see severe reactions by a few, procedure changes resulted. As in anything some will only see the negatives, others a future. there are no edits.........................
A total of 10 sobjects experienced serious side affects possibly related to the study treatment (surgery or spheramine)
Two subjects died. On subject died from cancer of the esophagas, which was considered entirly unrelated to sphermine treatment. The subject also had bleeding in the brain with temporary weakness of one body side, speech problems and seizures, which was thought to be related to study surgery.. Before he died from cancer he had recovered from symptoms of bleeding from the brain. One subject had a fall, broke a rib and acquired pulmonary infection and empyema and died. This subject also had transient confusion after surgery for one day. He then improved and then had markedly better UPDRS scores (by 23%), but later experienced mental and physical deterioration. Brain autoposy from this subject is available, it demonstrated vital hRPE cells on microcarriers in the brain.

One more subject had bleeding in the brain with temporary weakness of one body side, speech problems, and seizure. He also had a low blood pressure (hypotension) and required artificial respiration. These symptoms have meanwhile resolved, but required prolonged rehabilitation. After surgery and changes in the medication, another subject had dyskinesia (violent involentary movement) and difficulty breathing (asthma attack) taht required artificial respiration for a short period. This subject also had minor bleeding on the brain surface which was not thought to cause any symptoms. Two weeks later, this subject had a dilusional episode (period of confusion) accompanied by suicidal thoughts. these events resolved after adjustment of the subject's antiparkinsonian medication.

Another subject had transient (1day) weakness of one arm and an epileptic seizure resulting from the temporary occlusion of a brain vein. The subject recovered completely after one week.

One subject had experienced brief periods of confusion (lasting up to 5 days), which prelonged her post-surgical hospital stay. The confusion occured at the same time as thinking disorders and dystonia. She had additional temporary weakness lasting up to 7 days. She recovered from these symptoms and improved in her PD symptoms, however later in that course of the trial, the neurological status of this subject worsened including mental deterioration. She is living in a nursing home and needs a wheelchair and feeding by a tube going through her nose to the stomach. The causal relationship of this deterioration with Spheramine treatment is unclear.

One subject experienced worsening of dyskinesia one day after study surgery, which prolonged the post-surgical hospital stay. The symptoms resolved.

One subject experienced paranoid delusions and agitation during the night after surgery. Several weeks later, this subject developed depression. His symptoms are completely resolved.

Two subjects required a hospital stay due to paranoid thoughts and delusion that occured several months after surgery, one 14 months and one 5 months after study treatment. It is uncertain if these problems were related to study drug or would also have occured in the natural course of their disease. One of these two subjects was recovered after 3 weeks, one is recovering.

Another subject experienced neck pain since surgery. It was found that he had a broken neck vertebra, however it was unclear if this was related to surgery since he was known to have had neck surgery in 1995, and the fracture was not fresh when it was detected 6 months after surgery.

Based on the findings of an Independent Data Monitoring Committee (IDMC) comprised of internationally recognized Parkinson's Disease experts, the severity and frequency of these serious side effects are in line with the complications that could normally be expected after this type of intervention. In particular, it is not to be expected that such events will occur in association with sham "placebo" operations. Following recommendation of the Chairman of the IDMC, a number of additonal safety measures have been implemented in the study protocol.

In addition, the following non-serious events seen in study subjects were considered to be possibly, probably, or definitely related to surgery and/or to study drug (Spheramine or Placebo). Common events that occured in 5 or more (or >10%) of 52 subjects were: nausea, violent involuntary movement, altered muscle tone, hallucination and headache. The common AEs occuring in 3 or more (or >5%) of subjects were: slow heart beat, weakness, pain, impaired healing, blood pressure increased, balance disorder, disturbance in attention, slow reflexes, confusional state, depression, insomnia, high blood pressure and low blood pressure.
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Old 08-19-2007, 07:25 PM #7
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Default My heart goes out to you

Both the patient who passed and a patient ( i'll now assume is your mother) with a long nursing home stay, are outined in my previous post. As far as after care goes, the doctors who do our followup testing i consider score keepers. If your mother hasnt been seen by her surgeon, thats where I would start making some noise. My surgeon told me of some followups he had done including a DBS on one of his spheramine (evidently placebo) patients. So if he's doing DBS he must be available.

Other avenues include, Call the office of the Institutuional Review Board at the Hospital the surgery was performed. Speak to the Investigator for your study. Formally report conditions or injuries.

If you have no luck with study related personnel, next I'd go to the hospital review board. The last thing they want out there is this type of thing.

Good luck, God Bless
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Old 08-19-2007, 08:43 PM #8
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Thanks to those involved with this trial for sharing information. I'm very sorry for your mother and understand how upset you must be that people are not helping you. I think its important to tell your stories, because we are trying to improve the conditions for participants in PD trials, as are patients of other diseases. Although we have a healthy resentment for Amgen and for good reason about halting GDNF, it doesn't mean we hate all drug companies. However, they have been allowed to cover up far too much information, and communications about trials must increase among all participants, including patients.

We need for people to participate in these trials to survive, but at the same time should not have to tolerate conditions which can be avoided or prevented. It seems reasonable to expect a thorough understanding of the risks and a clear understanding of what is covered post trial at the very least. Just writing it in the consent is not enough. It should be gone over and repeated pre-trial and patients should be checked for comprehension when possible. Any other ideas for inclusion in a Bill of Rights are welcome. You trial participants are the expert witnesses.

Again, please keep us informed and thank you.
Paula
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Old 08-19-2007, 09:41 PM #9
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jllanguille

Thank you for returning with this information. I am so sorry it turned out to be your Mother. We will ask a million questions but you take your time and answer when you can and if you want to.

This has to be a horrendous happening for you and our thoughts are with you.

Thank you again hon

With much respect and appreciation

Thelma

Last edited by Thelma; 08-20-2007 at 11:24 AM.
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Old 08-20-2007, 02:01 AM #10
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Default jllanguille ...

I sympathise with your experience and respect your Mother's bravery in participating in the trial.

I remain positive about Spheramine and return to the comment in BobT's post :

"Based on the findings of an Independent Data Monitoring Committee (IDMC) comprised of internationally recognized Parkinson's Disease experts, the severity and frequency of these serious side effects are in line with the complications that could normally be expected after this type of intervention".

Compare Spheramine's safety profile with that of DBS for some perspective. The safety profile for DBS considered by the UK's National Institute for Clinical Excellence DBS consultation paper:

http://guidance.nice.org.uk/page.aspx?o=IP089

quotes DBS related side effects of :

Severe Dyskinesia, Haematoma, Transient Confusion, Stroke, Brachial plexus injury, Pulmonary embolism, Speech difficulties, depression, gait disorder, and death (amongst others) !!

jllanguille, I can only imagine what you are going through and do not wish to trivialise your experience. On balance I hear more good than bad re. Spheramine and continue to be hopeful that it will provide an exciting new option for us PWP.

Neil.

Last edited by aftermathman; 08-20-2007 at 10:43 AM.
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