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E. Ernst - One of the best experts on this subject based on the ideXlab platform.
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Chelation Therapy for coronary heart disease: An overview of all clinical investigations
American heart journal, 2000Co-Authors: E. ErnstAbstract:Abstract Background Chelation Therapy is popular in the United States. The question of whether it does more good than harm remains controversial. Aim The aim of this systematic review was to summarize all the clinical evidence for or against the effectiveness and efficacy of Chelation Therapy for coronary heart disease. Methods A thorough search strategy was implemented to retrieve all clinical investigations regardless of whether they were controlled or uncontrolled. Results The most striking finding is the almost total lack of convincing evidence for efficacy. Numerous case reports and case series were found. The majority of these publications seem to indicate that Chelation Therapy is effective. Only 2 controlled clinical trials were located. They provide no evidence that Chelation Therapy is efficacious beyond a powerful placebo effect. Conclusion: Given the potential of Chelation Therapy to cause severe adverse effects, this treatment should now be considered obsolete. (Am Heart J 2000;140:139-41.)
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Chelation Therapy for peripheral arterial occlusive disease : A systematic review
Circulation, 1997Co-Authors: E. ErnstAbstract:Chelation Therapy is viewed, promoted, and practiced as a form of complementary/alternative medicine (see References 1 and 21 2 ). It uses repeated intravenous administration of EDTA, usually in combination with vitamins, trace elements, and iron supplements as a treatment for a variety of diseases.3 4 5 Oral Chelation Therapy also has been advocated (see Reference 66 ) but will be excluded from this review. Among others, Chelation Therapy is claimed to be effective in reversing the arteriosclerotic disease process,7 8 in particular peripheral arterial occlusive disease (PAOD). Proponents claim that it can be an alternative for amputation in severe cases.8 This goes back to an observation made in the 1950s, when it was noted that patients undergoing EDTA Therapy for lead poisoning felt a relief of angina pectoris after this Therapy.9 While various authors9 10 11 12 13 14 15 have subsequently reported promising results in uncontrolled studies, others have been unable to confirm these in similarly designed trials.16 17 The debate of whether or not it is a useful form of Therapy for PAOD therefore continues.18 19 20 21 22 23 24 25 Meanwhile, numerous clinics have been set up in Europe, the United States, and elsewhere using and promoting Chelation Therapy for PAOD. In the light of recent trial data, it is therefore timely to systematically review the evidence from randomized, placebo-controlled, double-blind trials and ask whether Chelation Therapy for PAOD is safe and effective. Computerized literature searches were performed (Medline 1966 to 1996; CISCOM 1996, a database specialized in complementary/alternative medicine) to identify all studies on the subjects. Publications thus found were screened for further …
Norbert Gattermann - One of the best experts on this subject based on the ideXlab platform.
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overview of guidelines on iron Chelation Therapy in patients with myelodysplastic syndromes and transfusional iron overload
International Journal of Hematology, 2008Co-Authors: Norbert GattermannAbstract:Between 2002 and 2008, a number of consensus statements and guidelines were developed by various groups around the world to educate healthcare professionals on the treatment of myelodysplastic syndromes (MDS), including the management of transfusional iron overload with iron Chelation Therapy. Guidelines have been developed by The Italian Society of Hematology, The UK MDS Guidelines Group, The Nagasaki Group, The National Comprehensive Cancer Network, and The MDS Foundation. These guidelines show that the approaches to managing iron overload in patients with MDS are region specific, differing in their recommendations for when iron Chelation Therapy should be initiated and strategies for the ongoing management of iron overload. The guidelines all agree that red blood cell transfusions are clinically beneficial to treat the symptomatic anemia in MDS, and that patients with low-risk MDS receiving transfusions are the most likely to benefit from iron Chelation Therapy.
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Guidelines on iron Chelation Therapy in patients with myelodysplastic syndromes and transfusional iron overload
Leukemia Research, 2007Co-Authors: Norbert GattermannAbstract:Experts believe that iron overload is an important problem which could be avoided with suitable treatment. Guidelines on treating myelodysplastic syndromes (MDS) include sections on using iron Chelation Therapy to prevent or ameliorate transfusional iron overload. The proportion of MDS patients who may benefit from iron Chelation Therapy is 35-55%, depending on the length of survival necessary for iron to accumulate to a detrimental level. Candidates for iron Chelation are mainly patients with dyserythropoietic and cytopenic subtypes of disease, which fall into the International Prognostic Scoring System (IPSS) Low-risk or Intermediate-1-risk categories, with median survival of 3-6 years.
Ali T. Taher - One of the best experts on this subject based on the ideXlab platform.
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Iron overload and Chelation Therapy in myelodysplastic syndromes.
Critical reviews in oncology hematology, 2014Co-Authors: Sally Temraz, Khaled M. Musallam, Valeria Santini, Ali T. TaherAbstract:Iron overload remains a concern in MDS patients especially those requiring recurrent blood transfusions. The consequence of iron overload may be more relevant in patients with low and intermediate-1 risk MDS who may survive long enough to experience such manifestations. It is a matter of debate whether this overload has time to yield organ damage, but it is quite evident that cellular damage and DNA genotoxic effect are induced. Iron overload may play a critical role in exacerbating pre-existing morbidity or even unmask silent ones. Under these circumstances, iron Chelation Therapy could play an integral role in the management of these patients. This review entails an in depth analysis of iron overload in MDS patients; its pathophysiology, effect on survival, associated risks and diagnostic options. It also discusses management options in relation to Chelation Therapy used in MDS patients and the impact it has on survival, hematologic response and organ function.
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Effect of oral iron Chelation Therapy with deferiprone (L1) on the psychosocial status of thalassaemia patients.
Haematologia, 2001Co-Authors: Laila Zahed, Fadi H. Mourad, R Alameddine, S Aoun, Suzanne Koussa, Ali T. TaherAbstract:Beta-thalassemia requires life-long treatment, including regular blood transfusion and daily iron Chelation by desferrioxamine, which places considerable burden on the social and psychological life of patients. It is expected that oral Chelation Therapy, which is easier to administer, would improve their psychosocial status. In this sutdy, interviews were conducted with a series of 44 patients recently placed on oral Chelation Therapy to evaluate their reactions to the new treatment. Eighty-six per cent of patients complied better with the oral Chelation Therapy. Fifty per cent of patients mentioned that relief from the desferrioxamine pump was the major improvement, while 47% felt psychologically better. Fifty per cent of patients noted improvements in their relationships, while 63% noted increased social activities. Evaluation of a larger sample of patients over a longer period of time is needed in order to confirm the favourable results obtained in this study.
Gervasio A. Lamas - One of the best experts on this subject based on the ideXlab platform.
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Chelation Therapy to prevent diabetes-associated cardiovascular events.
Current opinion in endocrinology diabetes and obesity, 2018Co-Authors: Denisse Diaz, Vivian Fonseca, Yamil W Aude, Gervasio A. LamasAbstract:Purpose of reviewFor over 60 years, Chelation Therapy with disodium ethylene diamine tetraacetic acid (EDTA, edetate) had been used for the treatment of cardiovascular disease (CVD) despite lack of scientific evidence for efficacy and safety. The Trial to Assess Chelation Therapy (TACT) was develope
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Chelation Therapy to treat atherosclerosis, particularly in diabetes: is it time to reconsider?
Expert review of cardiovascular therapy, 2016Co-Authors: Gervasio A. Lamas, Ian ErguiAbstract:ABSTRACTIntroduction: Case reports and case series have suggested a possible beneficial effect of Chelation Therapy in patients with atherosclerotic disease. Small randomized trials conducted in patients with angina or peripheral artery disease, however, were not sufficiently powered to provide conclusive evidence on clinical outcomes.Areas covered: The Trial to Assess Chelation Therapy (TACT) was the first randomized trial adequately powered to detect the effects of Chelation Therapy on clinical endpoints. We discuss results and future research.Expert commentary: Chelation reduced adverse cardiovascular events in a post myocardial infarction (MI) population. Patients with diabetes demonstrated even greater benefit, with a number needed to treat of 6.5 patients to prevent a cardiac event over 5 years, with a 41% relative reduction in risk of a cardiac event (p = 0.0002). These results led to the revision of the ACC/AHA guideline recommendations for Chelation Therapy, changing its classification from class...
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Chelation Therapy and cardiovascular disease connecting scientific silos to benefit cardiac patients
Trends in Cardiovascular Medicine, 2014Co-Authors: Julio G Peguero, Ivan A Arenas, Gervasio A. LamasAbstract:Medical practitioners have treated atherosclerotic disease with Chelation Therapy for over 50 years. Lack of strong of evidence led conventional practitioners to abandon its use in the 1960s and 1970s. This relegated Chelation Therapy to complementary and alternative medicine practitioners, who reported good anecdotal results. Concurrently, the epidemiologic evidence linking xenobiotic metals with cardiovascular disease and mortality gradually accumulated, suggesting a plausible role for Chelation Therapy. On the basis of the continued use of Chelation Therapy without an evidence base, the National Institutes of Health released a Request for Applications for a definitive trial of Chelation Therapy. The Trial to Assess Chelation Therapy (TACT) was formulated as a 2 × 2 factorial randomized controlled trial of intravenous EDTA-based Chelation vs. placebo and high-dose oral multivitamins and multiminerals vs. oral placebo. The composite primary endpoint was death, reinfarction, stroke, coronary revascularization, or hospitalization for angina. A total of 1708 post-MI patients who were 50 years or older with a creatinine of 2.0 or less were enrolled and received 55,222 infusions of disodium EDTA or placebo with a median follow-up of 55 months. Patients were on evidence-based post-MI medications including statins. EDTA proved to be safe. EDTA Chelation Therapy reduced cardiovascular events by 18%, with a 5-year number needed to treat (NNT) of 18. Prespecified subgroup analysis revealed a robust benefit in patients with diabetes mellitus with a 41% reduction in the primary endpoint (5-year NNT = 6.5), and a 43% 5-year relative risk reduction in all-cause mortality (5-year NNT = 12). The magnitude of benefit is such that it suggests urgency in replication and implementation, which could, due to the excellent safety record, occur simultaneously.
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Chelation Therapy after the trial to assess Chelation Therapy: results of a unique trial.
Current opinion in cardiology, 2014Co-Authors: Maria D. Avila, Esteban Escolar, Gervasio A. LamasAbstract:Purpose of reviewEDTA Chelation Therapy has been in off-label use for the treatment of atherosclerosis. We review the results of the first large-scale randomized trial of this treatment.Recent findingsThe trial to assess Chelation Therapy was a $30 million National Institutes of Health-funded study
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Abstract 11546: Clinical Benefit of EDTA Chelation Therapy in Patients With Diabetes in the Trial to Assess Chelation Therapy (TACT)
Circulation, 2013Co-Authors: Esteban Escolar, Gervasio A. Lamas, Christine Goertz, Robin Boineau, Pamela Ouyang, Yves Rosenberg, Daniel B. Mark, Allan Magaziner, Ralph A. Miranda, Richard L. NahinAbstract:Chelation Therapy has been used to treat atherosclerotic disease. We reported the results of an NIH-funded trial demonstrating a significant reduction of a combined cardiovascular endpoint in post-...
Richard A. Anderson - One of the best experts on this subject based on the ideXlab platform.
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Acute prooxidant effects of vitamin C in EDTA Chelation Therapy and long-term antioxidant benefits of Therapy.
Free radical biology & medicine, 2005Co-Authors: Isabelle Hininger, Anne Marie Roussel, Mireille Osman, Karen Fernholz, Robert S. Waters, Catherine Garrel, Richard A. AndersonAbstract:Chelation Therapy is thought to not only remove contaminating metals but also to decrease free radical production. EDTA Chelation Therapy, containing high doses of vitamin C as an antioxidant, is often used in the treatment of diseases such as diabetes and cardiovascular diseases but the effectiveness of this treatment may be variable and its efficacy has not been demonstrated conclusively. The objective of this work was to determine if the vitamin C added to standard Chelation Therapy cocktails was prooxidant. We administered a standard EDTA cocktail solution with or without 5 g of sodium ascorbate. One hour following the standard Chelation Therapy, there were highly significant prooxidant effects on lipids, proteins, and DNA associated with decreased activities of RBC glutathione peroxidase and superoxide dismutase while in the absence of sodium ascorbate, there were no acute signs of oxidative damage. After 16 sessions of standard Chelation Therapy, the acute prooxidant effects of vitamin C remained, but, even in the absence of nutrient supplements, there were beneficial long-term antioxidant effects of Chelation Therapy and plasma peroxide levels decreased. In conclusion, multiple sessions of EDTA Chelation Therapy protect lipids against oxidative damage. However, standard high amounts of vitamin C added to EDTA Chelation solutions also display short term prooxidant effects. The added benefits of lower levels of vitamin C in Chelation Therapy need to be documented.
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Original Contribution Acute prooxidant effects of vitamin C in EDTA Chelation Therapy and long-term antioxidant benefits of Therapy
2005Co-Authors: Isabelle Hininger, Anne Marie Roussel, Mireille Osman, Karen Fernholz, Robert S. Waters, Catherine Garrel, Richard A. AndersonAbstract:Chelation Therapy is thought to not only remove contaminating metals but also to decrease free radical production. EDTA Chelation Therapy, containing high doses of vitamin C as an antioxidant, is often used in the treatment of diseases such as diabetes and cardiovascular diseases but the effectiveness of this treatment may be variable and its efficacy has not been demonstrated conclusively. The objective of this work was to determine if the vitamin C added to standard Chelation Therapy cocktails was prooxidant. We administered a standard EDTA cocktail solution with or without 5 g of sodium ascorbate. One hour following the standard Chelation Therapy, there were highly significant prooxidant effects on lipids, proteins, and DNA associated with decreased activities of RBC glutathione peroxidase and superoxide dismutase while in the absence of sodium ascorbate, there were no acute signs of oxidative damage. After 16 sessions of standard Chelation Therapy, the acute prooxidant effects of vitamin C remained, but, even in the absence of nutrient supplements, there were beneficial long-term antioxidant effects of Chelation Therapy and plasma peroxide levels decreased. In conclusion, multiple sessions of EDTA Chelation Therapy protect lipids against oxidative damage. However, standard high amounts of vitamin C added to EDTA Chelation solutions also display short term prooxidant effects. The added benefits of lower levels of vitamin C in Chelation Therapy need to be documented. Published by Elsevier Inc.
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EDTA Chelation Therapy does not selectively increase chromium losses
Biological Trace Element Research, 1999Co-Authors: Richard A. Anderson, Noella A. Bryden, Robert WatersAbstract:Chelation Therapy and supplemental Cr have both been shown to lead to improved blood glucose, lipids, and insulin activity. Chelation Therapy leads to the removal of toxic as well as essential metals. To determine if Chelation Therapy leads to increased urinary Cr losses and altered Cr homeostasis, 2 groups of subjects (1 group that had undergone only 1 or no Chelation Therapy and 1 group in which all subjects had undergone at least 19 Chelation sessions) were evaluated for differences in possible Cr homeostasis based on urinary Cr losses. There were no significant differences in urinary Cr losses between the two groups of subjects and there were no significant increases in urinary Cr losses resulting from Chelation Therapy. Increases in urinary Cr losses were strongly influenced by supplementation but not Chelation Therapy.