Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.
In regards to http://www.ncbi.nlm.nih.gov/pubmed/19181486
What kind of randomization results in Group A having 106 patients and Group B having 37 patients?
This may have been randomized, even if a suspicious sort of randomization, but this study was not blinded: Group A knew it was being treated extra well because it knew it was getting ProstaMEV and FlogMEV. Group A would not have known this if a placebo had been in use, but it was not. What is the effect on symptoms of the knowledge that you are being treated?
The followup of one month seems short for chronic prostatitis. What is the long-term durability of responses?
One month after treatment, 89.6% of patients who had received prulifloxacin associated with ProstaMEV and FlogMEV did not report any symptoms related to CBP, whilst only 27% of patients who received antibiotic therapy alone were recurrence-free
(P < 0.0001)
"Six months after treatment, no patients in Group A had recurrence of disease whilst two patients in Group B did."
I think that you might have missed it on the abstract where it said there was a followup of 6 months. Shame about the lack of placebo with the antibiotic in the other group, but given the significance of the results it might be worth those with prostatitis trying combination therapies using antibiotics and natural compounds. Although some caution should be taken as some compounds in foods are able to alter the pharmokinetics of certain drugs.
Yes, we have symptoms data for 1 month. And recurrence data for 6 months, at which point just about everyone -- with or without ProstaMEV and FlogMEV -- had no recurrence.
Lack of placebo is less about shame than about potentially biasing patient perception and thus self-reporting of symptoms. Had the control group gotten placebo, for all we know it would have fared better than the treatment group. Put another way, it may be that the ProstaMEV and FlogMEV are actually exerting a placebo effect -- causing the patients who take it to believe they are being treated and thus to feel better -- without actually being therapeutic. Without a control placebo blindly administered, this is a possibility that we cannot exclude.
This video provides a funny but legitimate exploration of the placebo effect.