BMAC for DDD= Good Alternative?

[DrCommonSense]

BMAC for DDD has been continuing to impress for DDD.

We all know the limited treatment options for discogenic back pain. PT, NSAIDs, Opioids, ESIs, etc have marginal utility for this problem.

BMAC has the real possibility of improvement of the actual disc morphology as the technology advanced from its rudimentary current state.

So far, studies have been promising:

http://onlinelibrary.wiley.com/doi/10.1002/stem.1845/epdf

Although this doesn't compare this treatment to other comparative modalities, BMAC is starting gain more credence for DDD than far more expensive modalities that have high morbidity/mortality levels with poor evidence such as fusion surgeries for discogenic back pain.

What is everyone's thoughts on this?

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[Ducttape]

Oh yes we can start doing this now!!!!

Small study, not blinded. Average age for degenerative dx is 40 years old, with an 18 year old subject, seems kind of young. Not a bad concept...

It may turn out similar to the methylene blue study and the Pauza discoseal study. Initial great results; no one ever reproduces results... Let's give it a little time and more research...



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[DrCommonSense]

Oh yes we can start doing this now!!!!

Small study, not blinded. Average age for degenerative dx is 40 years old, with an 18 year old subject, seems kind of young. Not a bad concept...

It may turn out similar to the methylene blue study and the Pauza discoseal study. Initial great results; no one ever reproduces results... Let's give it a little time and more research...



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Thats why I called it rudimentary in nature. However, I find it interesting and probably the future of medicine.

Regenerative medicine with more and more advanced biologics for injections will be the future for sports medicine/pain medicine as this stuff advances.

its extremely needed considering the alternatives are terrible for DDD.

 

[DrCommonSense]

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[Ducttape]

Thats why I called it rudimentary in nature. However, I find it interesting and probably the future of medicine.

Regenerative medicine with more and more advanced biologics for injections will be the future for sports medicine/pain medicine as this stuff advances.

its extremely needed considering the alternatives are terrible for DDD.

we have seen so many studies that are "probably the future of medicine" in the past 6-8 years (the time I have been in pain medicine) that have not panned out. out of all those "future of pain medicine" treatments, the only one I can say has shown persistent evidence of benefit has been high frequency stim.

give it time, see where it falls.

 

[DrCommonSense]

we have seen so many studies that are "probably the future of medicine" in the past 6-8 years (the time I have been in pain medicine) that have not panned out. out of all those "future of pain medicine" treatments, the only one I can say has shown persistent evidence of benefit has been high frequency stim.

give it time, see where it falls.

I agree but that is true in all fields of medicine.

I just believe stem cells have far more potential than something like methylene blue or other inert substances.

But you are right, time will tell.

Even with that little study, it now has more evidence than fusion surgery for treatment of discogenic pain for DDD. How crazy is that?

 

[DrCommonSense]

we have seen so many studies that are "probably the future of medicine" in the past 6-8 years (the time I have been in pain medicine) that have not panned out. out of all those "future of pain medicine" treatments, the only one I can say has shown persistent evidence of benefit has been high frequency stim.

give it time, see where it falls.

Mesoblast (company out of Australia) have gotten successful Phase 2 trials already in a smaller number of patients compared to placebo/alternative injections

Phase 3 trials have started last year and will be concluded by 2017. Should be very interesting.


https://ryortho.com/2015/08/stem-cell-treatment-for-ddd-enters-phase-3/

 

[SSdoc33]

injecting something into the disc is the holy grail for pain medicine. also, we'd be able to legitimately bill a discography code (yay!).

unfortunately, BMAC is probably just like the "original" holy grail: complete BS.

i agree that biologics are the future of medicine. that future is is pretty far away, though. i doubt ill be using any in my career.....

 

[DrCommonSense]

injecting something into the disc is the holy grail for pain medicine. also, we'd be able to legitimately bill a discography code (yay!).

unfortunately, BMAC is probably just like the "original" holy grail: complete BS.

i agree that biologics are the future of medicine. that future is is pretty far away, though. i doubt ill be using any in my career.....

Yeah we'll see. Large private companies are putting considerable money/research into these treatments. Mesoblast is now doing Phase 3 trials at many large medical centers after positive Phase 2 trials.

I have never seen this level of money come into the pain space for treatment options. VC/PE groups will continue to pour money into these treatments because its the "holy grail" for them as well (huge business).

Remember, the bar for treating DDD is quite low. All they really need to show is a positive outcome compared to fusion or other conserative treatments in head to head RCTs.

 

[SSdoc33]

Yeah we'll see. Large private companies are putting considerable money/research into these treatments. Mesoblast is now doing Phase 3 trials at many large medical centers after positive Phase 2 trials.

I have never seen this level of money come into the pain space for treatment options. VC/PE groups will continue to pour money into these treatments because its the "holy grail" for them as well (huge business).

Remember, the bar for treating DDD is quite low. All they really need to show is a positive outcome compared to fusion or other conserative treatments in head to head RCTs.

the money investment is a good sign, but whether or not we get paid for it is a different story. we have seen disc treatments come and go in the last 20 years as duct mentioned. again, id be shocked if these treatments are going to be helpful and available within 10 years

 

[deleted185747]

Also need to define what type of DDD responds.

 

[DrCommonSense]

the money investment is a good sign, but whether or not we get paid for it is a different story. we have seen disc treatments come and go in the last 20 years as duct mentioned. again, id be shocked if these treatments are going to be helpful and available within 10 years

Yeah I know alot of people are skeptical after IDET but I wouldn't write it off just yet considering this level of interest in "regenerative" medicine from VC/PE/investors is literally unprecedented in the pain space.

So many companies are jumping on board to get this off the ground now.

 

[Doctodd]

it works......am discussing research now.