An intense reactive arthritis after BCG no. 15

11 months 3 weeks ago #61661 by Jnani
Thank you very much Joea73!

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11 months 3 weeks ago #61649 by Alan
My treatment was once a week instillations for 6 weeks, then 6 weeks off followed by the cystoscopy. Then, another once a week treatment for 6 weeks.

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.

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11 months 3 weeks ago #61648 by joea73
Below is the link to the study that compared various BCG regimen.   Your doctor should have access to the detail report if required.  I have added exerts relating to the effects of different BCG treatment regimens on recurrence and progression.

pubmed.ncbi.nlm.nih.gov/28471272/


Effect on decreasing recurrence and progression rate
According to the results of conventional meta-analysis, maintenance BCG therapyin all reduces the incidence of recurrence over induction-only therapy, which is in accordance with the previous studies. However, as for the comparison among
different maintenance schedules using network meta-analysis, the longer term
schedules (for example, 3-year maintenance schedule) are not significantly superior to
the shorter maintenance terms (such as basic 1-year maintenance schedule) in
decreasing the tumor recurrence. The 3-year maintenance schedule has merely 8%
lower probability in recurrence than 1-year schedule in the SUCRA ranking.
Not to
mention the 2-year schedule even has higher recurrence SUCRA possibility than the
basic 1-year maintenance schedule. The 1.5-year maintenance therapy has “excellent”
performance in conventional meta-analysis as it significantly reduced tumor
recurrence. Such result may suggest an optimal schedule for intravesical BCG
maintenance therapy. However, the 1.5-year schedule was an unusual schedule and
only be reported in one study with 82 patients. More clinical trials are needed to
demonstrate the efficacy of this schedule .As for the progression, the conventional
meta-analysis suggests BCG maintenance therapy could not significantly reduce the
odd of the disease progression of the NMIBC over the BCG induction-only schedule.
The muscle invasion and distant metastasis have a bit of difference though they were
both defined as progression in this study, in the trial which reported these two
outcomes respectively, the outcomes unexpectedly suggest a higher distant metastasis
rate in maintenance BCG therapy group. Given that not all trials reported the
progression outcomes in details and the comparison evidence is relatively weak, the
reason why maintained intravesical BCG therapy increase the distant metastasis odd is
still unknown and further investigation is needed. Just like the ones of the recurrence,
the network meta-analysis results do not approve the longer maintenance schedules
reducing progression rate against the basic 1-year maintenance schedule even if the
SUCRA ranking indicates the probability in recurrence of 3-year maintenance
schedule is 20% lower.The above-mentioned results indicate that the longer
maintenance BCG therapy schedules do not have a better efficacy performance.

Internet says the SCURA (Surface Under the Cumulative RAnking curve) is a way to determine the best treatment based upon network meta-analysis. In this study, it was necessary to review various clinical studies done at different institutions. Network Meta Analysis is a process to statistically review multiple clinical trials and find the ranking of different treatments,  I am not good at statistics so that's all I can say for now.


best

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11 months 3 weeks ago #61647 by Jnani
This forum is the only place I consult, beyond the ongoing conversation with my doctors.
And I am always moved by the knowledge and the kindness.   Happy to have you!

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11 months 3 weeks ago #61646 by Jnani
Thank you very much Alen!
Sorry I did not understand the meaning of 6 weeks BCG, and 6 weeks off.     How many days of BCG / 1 year it makes?
Good! to hear that your treatment is successful anyway.

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11 months 3 weeks ago #61645 by Jnani
Dear Joeay73,

Thank you very much!  I will share this with the doctors involved.

Please, do you happen to have a link to the referred study?

Best wishes.

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