From what I saw of AM 101 the results turned out that AM 101 did not cure/help a lot of the people who took it
Earlier this year, I was in contact with one of the senior ENT physicians of the University Hospital of Leipzig for his evaluation of the phase-II results of the AM-101 trial (I have shared with
@Markku the follow-up 2-page letter that the doctor sent to my GP afterwards; so this is a fact and not an "Internet-story"). The doctor's opinion was that the results (of AM-101) were "not that good" and that the trial is "only for acute/3-month chronicity of tinnitus" - the implication being that it is unlikely to work for the trial associated with sub-acute tinnitus.
Indeed I have also myself voiced a slight skepticism from time-to-time in the AM-101 thread (due to the lack of "slam-dunk" cases of people getting cured after treatment). However... one of the things that the researchers Team Trobalt is corresponding with have told us is that tinnitus is a heterogeneous condition with several different sub-types. This means that the success rate of a given treatment can vary somewhat (and is also why screening and highly specific inclusion/exclusion criteria is important). But since subjective tinnitus cannot be diagnosed objectively, reliably finding the right candidates can present difficulties (and possibly influence the results of the trials). So this may be one reason why AM-101 did not do so well in the phase-II trial. [Incidently, the topic and importance of screening was also something I specifically discussed with Prof. Jeanmonod in Switzerland].
Another reason why AM-101 may not have performed so well in the phase II results could perhaps be related to the timing of injections (ie. chronicity of the tinnitus patients participating). There are certain physiological processes that take place right after an auditory insult...
While sensorineural hearing loss in the chronic stage is irreversible, all or part of it may recover in the acute stage thanks to cochlear repair mechanisms. The more severe the acute hearing loss is, the less likely spontaneous recovery becomes and the higher the risk for permanent damage and loss is. Usually, hearing recovery is most pronounced in the hours and days following the onset of acute hearing loss and tapering off over 4 to 5 weeks. In human beings, loss of cochlear hair cells or neurons is irreversible
Source: Auris Medical
...and so perhaps another reason for the disappointing result is related to the timeframe of which AM-101 is effective. And these specific timeframes is what a phase-III trial would aim to shed light on (because the number of participants is somewhat greater than in phase-II allowing for a more focused analysis).
Look at it this way: if the results had been truly mediocre for phase-II, Auris Medical would not even have considered going ahead with phase-III (in my opinion). The costs of running a phase-III trial is... well.. it's expensive! You can read their latest financial summary here (if it interests you):
https://www.sec.gov/Archives/edgar/data/1601936/000119312514253454/d684505df1.htm
So in summary, I still think there is reason to be cautiously optimistic. Hopefully the phase III trial will demonstrate efficacy in certain specific cases of cochlear tinnitus.
I should also mention that there are now therapies being developed by Auris Medical and Otonomy both (presumably) aimed at chronic cochlear tinnitus (AM-102 and OTO-311). As it happens, I will be heading down to see the doctor who was meant to have treated me with off-trial AM-101 back in May. I will be asking him about the component of OTO-311 which has already been used in another trial here in Germany. You can read about AM-102 here:
https://www.tinnitustalk.com/threads/auris-medical-am-102.7183/
and Autifony seems to be going the same way about their trials and such and people are expressing doubts about how the medicine will reach full potential in a trial period of only 4 weeks.
This is the Internet. And quite a number of posts in the AUT-63 phase-II thread reflects knowledge written by people who have no relevant insight, medical knowledge, or wish to track down reliable information. I have gone to extra lengths, as I always do, and tracked down reliable information from a leading researcher with insight of the trial. I have shared that insight. I have documented with
@Markku who the source is. The verdict is pretty clear: it is too early to draw any conclusions about whether the treatment length is right and/or whether AUT-63 will end up becoming curative in some cases. The researchers don't know - that's why they are running a clinical trial!
I have been in contact with the researcher three times. Most recently, a couple of weeks ago. They are still screening and recruiting participants. The researcher was therefore not willing to even attempt to answer whether certain trialees had seen good results. So don't start to draw conclusions about efficacy.
By the time they finish with these trials my T will be over a year old and therefore not fit to participate in that study. Not that I could even dream of having the money/time to go to the UK.
Inclusion/exclusion criteria will be open for review (for sure and confirmed). And so will the geographical scope, I imagine (in a future phase-III trial). You therefore cannot possibly know what the future will - or will not - bring. To the best of my knowledge, for example, the hearing loss trial (separate from the tinnitus one) of AUT-63 was meant to have taken place in the USA.
attheedgeofscience
31/DEC/2014.