Experts: Chelation Therapy Not Ready for Prime Time
New study shows slight effect, but arduous 'leaching' treatment has side effects, doctors say
Still, the gap was not huge and Lamas, who does not use chelation therapy in his own practice, said he cannot recommend it at this time. The researchers also noted that the drop-out rate among participants was relatively high: 281 people in the placebo arm stopped treatment before the study's end, as did 233 of those taking chelation.
"The message really is a cautious message," Lamas said. "We brought something that has been an alternative medicine treatment into the realm of scientific inquiry and found unexpected results that may merit future research. However, we don't think that the results of any single trial are enough to carry this novel hypothesis into daily use for patients."
In an editorial published in JAMA, the journal's editor-in-chief, Dr. Howard Bauchner said that "based on full consideration of the strengths and limitations of [this study], the conclusion is clear and should influence practice -- these findings do not support the routine use of chelation therapy as secondary prevention for patients with previous [heart attack] and established coronary disease."
But Green said the debate over chelation's effectiveness may continue.
"The use of chelation therapy for coronary artery disease has had its advocates for decades, but predominantly outside of regular medical circles," Green noted. "This is because there has not been what was considered a good hypothesis to explain why it should work for coronary atherosclerosis [hardening of the arteries]."
Beyond that are safety concerns linked to the therapy's removal of calcium from the bloodstream. In the study, the researchers noted that the treatment "may cause hypocalcemia [abnormally low calcium in the blood] and death."
Speaking at the time of the ACC meeting presentation in San Francisco, cardiologist Dr. Tara Narula, associate director of the cardiac care unit at Lenox Hill Hospital in New York City, was similarly dubious of chelation's usefulness.
"Although it is noteworthy that chelation may be helpful, it is an expensive treatment and does carry significant side effects," she said.