This piece has been entered in the Patients Have Power Writing Contest run by Clara Health designed to raise awareness about clinical trials.
“It’s a USB port for your brain, and it’s going to help you manage your fibromyalgia pain.” Imagine your doctor explaining this to you at your next appointment. She hands you the device – it looks like a headband with an electrode in the centre. “When the electrode makes contact with your forehead, it stimulates a nerve that connects directly with parts of the brain which regulate your nervous system. By wearing it twice a day for 20 minutes, your pain will be reduced and your mood will improve.” No drugs. No side effects.
Does this sound like science fiction? Amazingly, it may soon be a reality, thanks to a new clinical trial being conducted at the University of Cincinnati on an external Trigeminal Nerve Stimulation device. Research on these this device has shown positive results already for migraine, depression and PTSD.
Or how about sitting in a chair, drinking a cup of coffee, while a coil placed against the side of your head directs magnetic waves at areas deep inside your brain that are affected by fibromyalgia? This is called transcranial magnetic stimulation, and recent clinical studies have found significant pain reduction in people with fibromyalgia after twenty sessions spread over one month. These are just some of the next generation treatments for chronic pain currently being studied.
Since my diagnosis six years ago, I have tried dozens of treatments, prescribed by multiple specialists, with very limited results. I’m still unable to work full-time because of my chronic pain. The possibility that a new device, strategy or medication could reduce my pain so significantly that I could regain my activity levels seems like a dream just out of reach. I know that I’m not alone in this experience.
Given how critical it is for there to be safe and effective treatments for chronic pain, conducting new research has never been more urgent. I believe it is vitally important that people living with chronic conditions understand the research process and learn how they can advocate and participate in it, so that one day we can realize a world where chronic pain is easily treatable.
Participating in Research Trials: How to Ensure that the Future is Now
Treatment trials are necessary to get the gold stamp of approval for new medical interventions from the US Food and Drug Administration (FDA). Research proves that a new drug or approach is effective and safe. This validation is necessary for doctors to find out about new treatments and for insurance companies to cover the costs.
Ultimately, the only way that new treatments can be developed is if patients join clinical trials. Participating in medical research is the most proactive way patients can contribute to improving how fibromyalgia is understood and treated. Personally, I find the thought of channeling my frustration at the lack of treatment options and taking action by enrolling in a research study exciting and empowering.
Participants in clinical trials have the opportunity to access cutting-edge therapies before they are made widely available, often at leading medical facilities. Experimental treatments can be appealing to individuals who have failed to benefit from conventional treatments. There is no cost to participate in medical research and health insurance is not required. Additionally, some studies compensate individuals who join the clinical trial.
What Safeguards Are in Place to Protect Participants During the Research Process?
Many people are reluctant to consider enrolling in clinical trials because they worry about the safety of being a research “guinea pig”. This is a natural response when confronted with the unknowns of a new treatment. When I did my own research into the safety of clinical trials, I was reassured by the rigorous process that is in place to protect patients. It’s important to be aware that all experimental treatments come with the risk of side effects – and these can range from unpleasant to life-threatening, depending on the nature of the medical intervention being studied. You should discuss any potential treatment trials you are considering enrolling in with your healthcare provider first!
Before a study can be conducted, it has to be assessed by an Institutional Review Board, which is made up of doctors and laypersons. They evaluate the design of the study to ensure that participants have their rights protected and are not exposed to undue risk.
In order to participate in a treatment trial, you must give informed consent. This means you have had the purpose and process of the study explained to you, including any and all potential risks, and that you understand you can leave the study any time.
When you think of clinical trials, you probably think of pharmaceutical drugs. But, did you know that many clinical trials focus on alternative and complementary therapies (like massage or acupuncture), mind/body therapies (like meditation), lifestyle changes (like exercise) and medical devices? Some people may be interested in participating in research studying these non-drug pain management strategies (like these arthritis clinical trials that don’t explore new drugs).
However, research on new pharmaceutical drugs is required to follow a lengthy series of trials and evaluations – actually more so than for any other medical intervention. New medications are only tested in human participants after years of research on tissues from animals and human cells, followed by testing in animal subjects to evaluate safety. The US Food and Drug Administration (FDA) reviews this data before approving human testing of a new pharmaceutical. Clinical trials involving human participants must progress through three phases of testing before the FDA approves a new medication for widespread use. It’s no wonder that it takes years for new treatments to get approved!
Phase 1 – healthy volunteers are administered the medication in order to evaluate the safety of the medication on the liver, kidneys and other organs
Phase 2 – a group of participants who live with the targeted condition are administered the medication in order to assess its efficacy
Phase 3 – large-scale trials are conducted in order to demonstrate that the medication offers statistically significant benefits for the particular disorder, as well as assess its safety profile and adverse side effects
I hope that by having a better understanding of the research process, and the safeguards that are in place to protect participants, people living with poorly understood and undertreated conditions like fibromyalgia will consider joining clinical trials. It’s a very personal decision, and may not be right for everyone. But those who do participate will be helping others by contributing to new insights and better treatments for chronic illnesses. If you are interested in learning more about participating in clinical trials, or looking for research studies recruiting volunteers in your area check out Clara Health, https://www.clinicaltrials.gov/ or http://www.centerwatch.com/.
Cort Johnson. (2016). ‘Coils, Lasers and USB Ports to the Brain: the Fibromyalgia Clinical Trials Overview.’ Health Rising. Retrieved June 1 2018 https://www.healthrising.org/blog/2016/12/17/fibromyalgia-clinical-trials-overview-2017/
NFMCPA. (n.d.) What are Clinical Trials and What to Consider about Participating. Retrieved June 1 2018 https://www.fmcpaware.org/what-are-clinical-trials-and-what-to-consider-about-participating