IDSA vindicated after unfair Blumenthal attack

Connecticut Attorney General Richard Blumenthal demonized the Infectious Disease Society of America after the release of its 2006 Lyme disease guidelines that rejected the long-term use of antibiotics because they were ineffective and dangerous. A comprehensive evaluation of those guidelines has now concluded the IDSA was right, the attorney general wrong.

"Based on its review of all the evidence and information provided, the Review Panel determined that no changes or revisions to the 2006 Lyme Guidelines are necessary at this time," the special panel announced Thursday. The vote was 8-0.

The attorney general needlessly politicized the issue by trying to make whipping boys of the IDSA. He raised tenuous allegations of conflicts of interest and blamed the group because insurance companies were refusing to pay for long-term antibiotic treatment. It was political grandstanding.

Among Mr. Blumenthal's claims was this: "The IDSA's guideline panel improperly ignored or minimized consideration of alternative medical opinion and evidence regarding chronic Lyme disease."

In other words, the attorney general suggested the association cooked the results. That's a serious charge and one that the review panel found was baseless.

It determined the guidelines "were based on the highest-quality medical/scientific evidence available" and that it "did not find that the authors of the 2006 Lyme Guidelines had failed to consider or cite relevant data and references that would have altered the published recommendations."

The special review panel was formed after Mr. Blumenthal threatened to take antitrust action against IDSA. Society President Dr. Richard Whitley said Thursday the legal attack on medical guidelines by an attorney general was unprecedented.

Mr. Blumenthal and IDSA agreed to let Dr. Howard Brody, a medical ethicist at the University of Texas Medical Branch, screen all panelists for any conflicts of interest. The panel spent a year exhaustively reviewing the guidelines, conducted a public hearing and took evidence from more than 150 individuals or organizations before issuing its 66-page report with 1,025 citations.

It determined what the IDSA and other groups, such as the American Academy of Neurology, have been saying for several years - clinical trials have showed little benefit from prolonged antibiotic therapy. Such treatments, using intravenous catheters, can cause life-threatening infections and other medical problems.

This unequivocal conclusion raises serious questions about the appropriateness of a 2009 Connecticut law that protects doctors prescribing long-term antibiotics for Lyme disease from sanctions by state health regulators.

A short course of oral antibiotics remains the standard treatment for patients with Lyme disease, the most common tick-borne illness. For most people, that quickly clears up the problem.

This report will not satisfy many of those who suffer from what they consider "chronic Lyme disease" or "post-Lyme disease syndrome," the joint soreness, fatigue, headaches and other lingering pain that continues long after the initial infection. The evidence is growing, however, that these symptoms result from a subsequent inflammatory condition rather than persistent infection with Lyme disease bacterium, making continuing antibiotic treatment useless.

Adding to the frustration of these patients and their physicians is the fact that other illnesses mimic the symptoms cited by long-term Lyme sufferers, adding to the challenge of diagnosis and treatment.

Mr. Blumenthal issued a brief statement that his office is reviewing the panel's report to assure it met the requirements set out before the panel began its work. What he should be offering is an apology. His attack on the work of the IDSA was needlessly over the top. The association did its job. It followed the science.

The Day editorial board meets regularly with political, business and community leaders and convenes weekly to formulate editorial viewpoints. It is composed of President and Publisher Tim Dwyer, Editorial Page Editor Paul Choiniere, Managing Editor Tim Cotter, Staff Writer Julia Bergman and retired deputy managing editor Lisa McGinley. However, only the publisher and editorial page editor are responsible for developing the editorial opinions. The board operates independently from the Day newsroom.

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