WED Found. Consensus Statement (Revised Mayo Clnic Algorthm)

For everything and anything else not covered in the other RLS/WED sections.
ViewsAskew
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WED Found. Consensus Statement (Revised Mayo Clnic Algorthm)

Postby ViewsAskew » Fri Sep 06, 2013 6:45 am

The Mayo Clinic has one again worked with the Foundation to create a treatment algorithm - they are calling is a consensus statement. They've taken into account the issues with dopamine agonists, from what I've heard, and that there are new drugs available. This is basically a NEW and IMPROVED RLS/WED Treatment Algorithm.

http://www.youtube.com/watch?v=HRuX3cWUOnE

That is a video of Dr Silber, who has sat (and maybe currently does) on the Foundation's medical advisory board and is a physical at Mayo.

The link to the proceeding is supposedly somewhere on this page. http://www.mayoclinicproceedings.org/ Indeed, I found it here: http://www.mayoclinicproceedings.org/ar ... 4/fulltext
Ann - Take what you need, leave the rest

Managing Your RLS

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jul2873
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Re: Willis-Ekbom Disease Foundation Revised Consensus Statem

Postby jul2873 » Fri Sep 06, 2013 2:59 pm

Thanks, Ann. This is very helpful to have.

Mary

Polar Bear
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Re: Willis-Ekbom Disease Foundation Revised Consensus Statem

Postby Polar Bear » Fri Sep 06, 2013 10:40 pm

I have it now saved over to my bookmarked favourites.
It's always good to have up to date documentation at hand for reference.
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

ViewsAskew
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Re: Willis-Ekbom Disease Foundation Revised Consensus Statem

Postby ViewsAskew » Sat Sep 07, 2013 10:05 pm

This is my favorite quote so far:

"Most recently, the International RLS Study Group has published evidence-based and clinical consensus best practice guidelines for the long-term management of RLS/WED.24 Although evidence-based reviews are valuable, they may not in isolation be helpful for the primary care clinician trying to determine the optimal therapy for a particular patient. Conclusions from such reviews are constrained by the breadth and quality of the published peer-reviewed literature. The highest level of evidence usually requires large multicenter studies that are almost always funded by the manufacturer of the drug to be tested. Thus, the degree of evidence to support a specific medication may depend on whether a pharmaceutical manufacturer has been willing to fund large studies. For similar reasons, few, if any, large comparative studies of different drugs have been published. Large controlled trials usually test short-term use of drugs, and long-term studies generally provide lower levels of evidence, being either uncontrolled prospective or retrospective studies. Nevertheless, data on continued use of medication in the community may be highly relevant for medical practice. For many of these reasons, evidence-based reviews generally make authoritative statements on the degree of evidence in support of the use of each medication for a defined disorder, but they are not always conducive to the development of practical algorithms for the management of disorders of varying severity and a lengthy natural history. For relatively rare conditions managed predominantly by specialists with considerable experience and a reasonable knowledge of the published literature, evidence-based reviews may be sufficient. However, for primary care physicians seeking a practical approach to common disorders, evidence-based reviews alone may be insufficient."

I was so worried when the evidence-based guidelines came out - they don't take into account many things. Because no one has every studied - large scale, peer reviewed, double-blind - opioids, this made it sound as if there was NO reason to ever prescribe them. Golly, I don't want my doctor reading that! Or yours, or anyone elses! Not without context, that is.

This provides context. Thank you, thank you, thank you.!
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Willis-Ekbom Disease Foundation Revised Consensus Statem

Postby ViewsAskew » Sat Sep 07, 2013 10:06 pm

My next favorite quote is this:

"The effort was supported by the board of directors and executive director of the Willis-Ekbom Disease Foundation, but this article is entirely the unpaid work of the physicians and scientists on the MAB."

These people did it UNPAID!!!!!!!!!

They are my heroes.
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Polar Bear
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Re: Willis-Ekbom Disease Foundation Revised Consensus Statem

Postby Polar Bear » Sun Sep 08, 2013 3:08 am

Super Heroes :clap:
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

badnights
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Re: Willis-Ekbom Disease Foundation Revised Consensus Statem

Postby badnights » Mon Sep 09, 2013 6:12 am

All the more reason to send them thank-you cards
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

Polar Bear
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Re: Willis-Ekbom Disease Foundation Revised Consensus Statem

Postby Polar Bear » Mon Sep 09, 2013 11:04 pm

:clap: Absolutely !!
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

badnights
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Re: Willis-Ekbom Disease Foundation Revised Consensus Statem

Postby badnights » Tue Sep 10, 2013 7:38 am

I'm disappointed in how this consensus statement deals with the treatment of augmentation. It is limited to two points (9 and 10), which say (I'm paraphrasing):
Try splitting the dose. If that doesn't work, try increasing the dose but watch for progressive augmentation. If that happens, stop the DA. If it's pramipexole or ropinirole you stop, try rotigotine patch but be careful. If adverse effects happen with rotigotine, don't use DAs at all.

Nothing about the exacerbated symptoms, no suggestions on how to relieve them.
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.


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