Chronic Lyme disease: Doctors seek answers

In a 2017 issue of the American Journal of Medicine [1], Dr. Rosalie Greenberg from Overlook Hospital in Summit, New Jersey, responds to an article published by Drs. Shapiro, Baker and Wormser entitled “False and Misleading Information about Lyme Disease.” [2]

 

Greenberg’s Letter to the Editor states, “The recently published article by Shapiro et al hoped to be topical in this age of ‘alternative facts’ but fell short, providing mainly biased viewpoints that prevent independent assessment of existing research in chronic Lyme disease. Presenting this conclusion as unquestionable is misleading.” [1]

Shapiro and colleagues began their article writing, “Recently, there has been considerable interest in the topic of fake news. For infectious diseases physicians, false and misleading information about the diagnosis and treatment of Lyme disease is not new. It is increasing in frequency and prominence, creating much confusion among primary care physicians and their patients.” [2]

The authors dismiss the need for retreatment with antibiotics, stating, “results of multiple clinical trials show that patients with well-documented Lyme disease who have residual nonspecific symptoms after treatment do not benefit from additional treatment, even with extended courses of IV antibiotics.” [2]

Greenberg’s letter expressed concern over the quality of data from the clinical trials cited by Shapiro and colleagues. Her concerns included the following:

• “Critical statistical reviews of American antibiotic retreatment studies by more than one research group concluded that these trials were underpowered, did not prove that retreatment was ineffective, and found support for a possible role of antibiotics in retreatment of chronic Lyme disease.”

• “Two trials demonstrated improvement in patients with severe significant symptoms at baseline.”

In turn, Shapiro responded to Greenberg’s letter, simply stating, “Most ─ if not all ─ of the issues raised by Greenberg in regards to our recent article have been addressed in detail in a previous publication in this journal.” [2]

Greenberg concludes, “The authors’ claim that definitive, rigorous, evidence based research exists regarding treatment of chronic Lyme disease is a disservice to fellow physicians and suffering patients alike. More and better-designed treatment studies in chronic Lyme disease are clearly needed.” [1]

 

References:

  1. Greenberg R. Chronic Lyme Disease: An Unresolved Controversy. Am J Med. 2017;130(9):e423.
  2. Shapiro ED, Baker PJ, Wormser GP. False and Misleading Information about Lyme Disease. Am J Med. 2017.


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Calum Grant, PhDRosalie Greenberg, MDKarlaL Recent comment authors
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Calum Grant, PhD
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Calum Grant, PhD

Patients like myself are getting fed up with what seem like semantic arguments: it is active Borreliosis, or is it something else. It’s obvious that something is going on; there is a medical condition that needs treating. By closing off the argument, Shapiro et al. are doing patients a great disservice. They show a remarkable lack of scientific curiosity in why such a large proportion of people with obvious tick bites and EM rashes either fail the 2-tier test or have lingering life-changing symptoms. A large chunk of patients are respond to antibiotics, but given the current scientific uncertainties, treatment… Read more »

Rosalie Greenberg, MD
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Rosalie Greenberg, MD

Thank you Dr. Cameron for sharing the letter that I wrote to the editor of the American Journal of Medicine regarding a poorly written biased article. I am grateful that my letter was published. The response of the authors is quite telling. Their Reply “Most—if not all—of the issues raised by Greenberg in regards to our recent article1 have been addressed in detail in a previous publication in this journal.2 Her concerns with respect to the work of Berende et al likewise have been addressed at length in a commentary by Melia and Auwaerter. Eugene D. Shapiro, MD Phillip J.… Read more »

KarlaL
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It is notable that authors of the disputed AJM journal article are the same people who have been targeting Julia Bruzzese, with disastrous results for her and her family. https://on-lyme.org/en/sufferers/lyme-stories/item/260-the-ultimate-lyme-test-julia-s-story The AJM article cites an American Lyme Disease Foundation paper (authored by Philip Baker), that was published in response to the award-winning Pei-sze Cheng I-Team investigative report on Julia. At the time the segment was airing, Dr. Baker sent copies of the ADLF paper (without permission) to her father’s personal email list of friends and family members. Both Dr. Gary Wormser and the American Lyme Disease Foundation paper made public… Read more »