Precision medicine: retrospective chart review and data analysis of 200 patients on dapsone combination therapy for chronic Lyme disease/post-treatment Lyme disease syndrome: part 1.
Level 4 - case-series / case-control
Uncontrolled retrospective chart review and single-arm before-and-after survey
PubMed 30863136 · doi:10.2147/IJGM.S193608
What was done
A retrospective chart review and online survey evaluated 200 adult patients ill for at least one year with chronic Lyme disease or post-treatment Lyme disease syndrome (PTLDS) from a specialized medical practice. Patients received dapsone combination therapy (DDS CT) combined with other antibiotics and biofilm-disrupting agents. Symptom severity across eight major Lyme symptoms was assessed via an online questionnaire before treatment and after six months of therapy, analyzed with paired-samples t-tests and Wilcoxon signed-rank tests alongside laboratory testing for coinfections.
What was found
The abstract reports that dapsone combination therapy statistically improved eight major Lyme symptoms after six months of treatment, but provides no numerical scores, effect sizes, or p-values. High frequencies of co-occurring intracellular bacterial infections (including Rickettsia, Bartonella, Mycoplasma, Chlamydia, Tularemia, and Brucella species), Babesia species, and reactivation of human herpesvirus 6 were also observed.
Why it matters
This study provides observational data on multi-drug dapsone regimens targeting persister forms in patients with persistent symptoms attributed to chronic Lyme disease and tick-borne coinfections.
Limits
The study lacked a control or placebo group, precluding causal inference or separation of treatment effects from placebo response, concurrent therapies, and natural symptom fluctuation. No numerical symptom scores or effect sizes are reported in the abstract. Data were derived from self-reported surveys within a single specialized private practice, introducing substantial selection and recall biases.
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- context In a study of 375 patients, dapsone combination therapy statistically improved patients' memory as its primary effect.