• [ 3 ] Approximately 90% of patients with GPA respond to cyclophosphamide, with approximately 75% experiencing complete remission. (medscape.com)
  • Since introduced by Fauci et al in the 1970s, oral cyclophosphamide in combination with high-dose glucocorticoids (ie, prednisone 1mg/kg/day) has been the criterion standard for induction of remission in AAV. (medscape.com)
  • Eventually, intravenous cyclophosphamide was investigated as an alternative to oral cyclophosphamide in an effort to decrease treatment-associated toxicities, and, while the emphasis has been placed on optimizing treatment by minimizing exposure to cyclophosphamide and seeking alternative comparable therapies, the combination of cyclophosphamide (intravenous or oral) and glucocorticoids remained the recommended therapy for induction of remission in generalized/severe GPA for years. (medscape.com)
  • In 2011, however, the US Food and Drug Administration (FDA) approved the use of rituximab (a monoclonal antibody that targets B cells), in combination with glucocorticoids, as an alternative to cyclophosphamide for induction of remission in AAV (GPA and microscopic polyangiitis). (medscape.com)
  • Chemotherapy was initiated according to the protocol on remission induction of COAP (cyclophosphamide, vincristine, cytosine arabinoside and prednisone) for a six week period achieving total remission of the neoplasia. (vin.com)
  • In this multicentre, prospective randomized controlled clinical trial, patients with generalized WG were treated either with oral LEF 30 mg/day or oral MTX (starting with 7.5 mg/week reaching 20 mg/week after 8 weeks) for 2 yrs following induction of remission with cyclophosphamide. (uni-luebeck.de)
  • Describe the unique features of acute promyelocytic leukemia (AML M3), including the morphologic appearance of the promyelocyte, hemorrhagic complications, chromosomal abnormality, and treatment with induction therapy and all trans retinoic acid. (hematology.org)
  • PRIMARY OBJECTIVES: I. Determine maximum tolerated dose (MTD) of MEK162 (MEK inhibitor MEK162 ) in patients with RAS-mutated acute myeloid leukemia ( AML ) when combined with sequential induction chemotherapy (3 +4 ) as measured by development of grade 3-4 dose-limiting toxicities (DLT). (mycancergenome.org)
  • Volasertib is under evaluation for the treatment of patients aged 65 or older with previously untreated acute myeloid leukemia (AML), who are ineligible for intensive remission induction therapy. (pharmamanufacturing.com)
  • Retrospective analysis by the Center for International Blood and Marrow Transplant Research (CIBMTR): Prompt complete remission plus consolidation therapy yields improved survival after allogeneic hematopoietic cell transplantation (allo-HCT) for patients with acute myeloid leukemia (AML) receiving a myeloablative conditioning regimen and not a reduced-intensity conditioning regimen. (ascopost.com)
  • CONCLUSION: Accelerated RT after CT as delivered in this study may increase both acute and long-term morbidity rates compared with studies using standard RT after CT. (duke.edu)
  • Results from a phase 2 study showed that a 2-step induction regimen involving dasatinib and intensive chemotherapy was associated with high rates of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients younger than 65 years with Philadelphia chromosome-positive (Ph+), newly diagnosed acute lymphoblastic leukemia (ALL), as well as improved 3-year overall survival (OS) rates for those undergoing allo-HSCT compared with those who did not. (cancertherapyadvisor.com)
  • TPMT polymorphisms and minimal residual disease after 6-mercaptopurine post-remission consolidation therapy of childhood acute lymphoblastic leukaemia. (cancercentrum.se)
  • Initial response to therapy, frequency of relapses, number of patients going into remission, time to remission, and daily dose of steroids were the same in both groups. (nih.gov)
  • In both 54-week trials, infliximab-dyyb demonstrated superiority to placebo in the primary endpoints of clinical remission (UC and CD) and endoscopic response (CD) when given as maintenance therapy after induction therapy with IV infliximab. (medscape.com)
  • In the randomized, placebo-controlled, double-blind LIBERTY-UC study, 438 patients with moderately to severely active UC after induction therapy with IV infliximab were randomly assigned at week 10. (medscape.com)
  • In the similarly designed LIBERTY-CD study, 343 patients with moderately to severely active CD after induction therapy were randomly assigned at week 10. (medscape.com)
  • Therapy of AML commonly consists of an induction phase, followed by a consolidation phase. (hematology.org)
  • But these drug combinations, called induction therapy , are incredibly taxing on the body. (cancer.gov)
  • For these patients, "and for people with many other coexisting medical problems, the ability to survive induction therapy is low. (cancer.gov)
  • Even in very healthy people over the age of 75, AML may not respond to induction therapy, she added. (cancer.gov)
  • With considerable advances in therapy, including the introduction of ATRA initially as a single agent and then in combination with anthracyclines, and more recently by development of arsenic trioxide (ATO)-containing regimens, APL is now characterized by complete remission rates of 90% and cure rates of ∼ 80%, even higher among low-risk patients. (nature.com)
  • In 1973, daunorubicin (DNR) was shown to increase remission rates from 13 to 58% and to reduce hemorrhage-related mortality after 5 days of therapy relative to 6-MP-based regimens. (nature.com)
  • Participants were randomly assigned to receive 45 mg of upadacitinib or placebo (2:1) for induction therapy to assess its effectiveness in achieving remission in two double-blind phase 3 trials, U-EXCEL and U-EXCEED. (mountsinai.org)
  • Patients who had a clinical response to upadacitinib induction therapy were then randomly assigned in the U-ENDURE maintenance trial to receive 15 mg or 30 mg of upadacitinib, or placebo (1:1:1) once daily for 52 weeks. (mountsinai.org)
  • Upadacitinib demonstrated superior efficacy over placebo, with a statistically significant proportion of patients achieving clinical remission after induction therapy. (mountsinai.org)
  • During the maintenance phase, the therapy substantially reduced the rate of disease relapse, illustrating its potential as a long-term treatment option for Crohn's disease. (mountsinai.org)
  • Most veterinary oncologists agree that unless palliation rather than extended remission is the goal of therapy, single agent treatment of lymphoma should be avoided. (vin.com)
  • Adhesion to the bone marrow (BM) niche is critical for AML initiation, progression and leukemic stem cell (LSC) survival after induction therapy. (confex.com)
  • Disease progress and response to therapy can be monitored by following laboratory values, including the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level. (medscape.com)
  • There are 2 forms of treatment for AML: induction therapy for complete remission (CR) and consolidation therapy to maintain CR. (pharmacytimes.com)
  • After induction therapy, a patient is given consolidation therapy done with high-dose cytarabine. (pharmacytimes.com)
  • The Phase III trial, known as POLO-AML-2 (Clinical Trial Identifier: NCT01721876), is a randomized, double-blind study designed to assess the efficacy and safety of Volasertib in combination with low-dose cytarabine (LDAC), compared to placebo in combination with LDAC, as a potential treatment for patients aged 65 or older with previously untreated AML who are ineligible for intensive remission induction therapy. (pharmamanufacturing.com)
  • The primary outcomes were the clinical remission rate at week 16 and the cumulative relapse rate 48 weeks after receiving induction therapy. (biomedcentral.com)
  • In addition, a secondary loss of response, defined as worsening of symptoms, can occur as a result of active IBD during maintenance therapy in patients with prior disease control after induction therapy. (biomedcentral.com)
  • This large retrospective analysis on behalf of the CIBMTR shows again that among patients eligible for allo-HCT, only one induction cycle to achieve first complete remis sion, particularly when combined with one consolidation therapy, is associated with better outcomes after myeloablative conditioning and not reduced-intensity conditioning. (ascopost.com)
  • nonetheless here is a consensus between the authors as to which rarely a rescue therapy provides a remission of long duration. (vin.com)
  • At presentation 3 months after RTX therapy, all ANCA-positive and ANCA-negative patients had responded to RTX, with one patient being in complete remission, and eight patients being in partial remission. (biomedcentral.com)
  • Depending on severity of the disease, immunosuppressants like methotrexate (MTX) or azathioprine (AZA) can also be used for remission induction and are often used along with glucocorticoids for maintenance therapy. (biomedcentral.com)
  • To date, no clear disease-stage-specific therapy regimen exists for remission induction and maintenance therapy. (biomedcentral.com)
  • Estimate the failure-free survival rate in a cohort of relapsed Hodgkin's lymphoma and non-Hodgkin's lymphoma patients after retrieval therapy which includes peripheral blood stem cell transplantation (PBSCT) in patients who achieve a complete remission or partial remission. (knowcancer.com)
  • While the standard-of-care in Japan for the treatment of younger patients with newly diagnosed Ph+ ALL is allo-HSCT preceded by imatinib plus intensive chemotherapy induction therapy, 30% to 40% of patients treated with this regimen in clinical trials were unable to undergo allo-HSCT due to older age, early relapse, or therapy-related death. (cancertherapyadvisor.com)
  • however, patients who achieved hematologic complete remission (HCR) following consolidation therapy who had an appropriate donor underwent allo-HSCT during consolidation. (cancertherapyadvisor.com)
  • Previously reported results demonstrated that both 3-year EFS and 3-year OS were improved for the overall study population of patients with newly diagnosed Ph+ ALL receiving dasatinib-based therapy compared with imatinib-based induction therapy. (cancertherapyadvisor.com)
  • The rate of HCR after induction therapy was 100%, and 21.8%, 52.6% and 57.7% achieved molecular complete remission (MCR) after induction therapy, intensive consolidation therapy, and the first cycle of consolidation therapy, respectively. (cancertherapyadvisor.com)
  • No induction therapy-related deaths were reported. (cancertherapyadvisor.com)
  • A cross-study comparison of these results with the PH+ALL202 study involving imatinib-based induction therapy did not show significant differences in these rates. (cancertherapyadvisor.com)
  • Results showed that 80 percent of trial participants experienced a complete or partial remission of their cancer. (wikipedia.org)
  • Be able to state the approximate success rate of chemotherapy for AML (rate of complete remission with induction chemotherapy and cure rate). (hematology.org)
  • If possible, people newly diagnosed with AML receive an intensive regimen of multiple chemotherapy drugs, with the goal of pushing the disease into a complete remission -that is, eliminating leukemia cells in the bone marrow . (cancer.gov)
  • Overall, COP chemotherapy causes complete remission in about 70% of dogs with lymphoma for a median of 130 days. (vin.com)
  • Complete remission was achieved in 84% of dogs for a median of about 9 months. (vin.com)
  • Perform preliminary efficacy analysis of combination of MEK162 and induction chemotherapy (3 +4 ) in patients with RAS-mutated AML by measuring complete remission rate, 2-year overall survival, and duration of response. (mycancergenome.org)
  • An important and unanswered question concerns the impact of the number of conventional AML chemotherapy induction cycles to achieve first complete remission on transplant outcomes. (ascopost.com)
  • Similarly, the outcomes of myeloablative conditioning and reduced-intensity conditioning regimens for allo-HCT and their relationship with pretransplant consolidation cycles for patients in first complete remission are also unknown. (ascopost.com)
  • 01). Treatment-related mortality was similar for patients with primary induction failure vs those in first complete remission after myeloablative or reduced-intensity conditioning allo-HCT (Table 1). (ascopost.com)
  • Compared with the poor outcomes of patients who received allo-HCT during refractory (active) disease, the outcomes of patients who received more than one induction cycle to achieve complete remission is somewhat better but remains unsatisfactory. (ascopost.com)
  • In a 24-week open-label induction study of 370 patients with class III-V lupus, there were no differences in the primary end-point (a prespecified decrease in urine protein/creatinine ratio and stabilization or improvement in serum creatinine) or the secondary end-point (complete renal remission, systemic disease activity and damage, and safety). (ukidney.com)
  • Estimate the post complete/partial remission failure-free survival rate in these patients. (knowcancer.com)
  • We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging. (lu.se)
  • The patient entered complete remission. (cdc.gov)
  • In parallel, the endoscopic response rate at week 54 was also greater in the infliximab-dyyb arm than in the placebo arm (51.1% vs 17.9%, respectively). (medscape.com)
  • Data from a phase 3 trial published today in The New England Journal of Medicine show that upadacitinib-a breakthrough, once-daily oral medication-helps patients achieve and maintain clinical and endoscopic remission. (mountsinai.org)
  • Corresponding author Jean-Frederic Colombel, MD , notes, "Upadacitinib addresses an unmet need in the treatment of Crohn's disease and allows patients access to an oral medication that could put them in clinical and endoscopic remission. (mountsinai.org)
  • At week 8, patients (n=961) were evaluated for clinical remission, endoscopic healing, clinical response, change from baseline in the IBDQ score, and mucosal healing (an endpoint that includes both endoscopic healing and histologic healing). (jnj.com)
  • 0.001), as compared to initial partial remission or non-response. (aging-us.com)
  • Clinical response was achieved in 137 patients (75.7%), and remission in 84 (46.4%) with higher rates of response (85.2% vs 61.6%, p=0.001) and remission (54.6% vs 34.2%, p=0.006) in biologic naïve patients compared to biologic-exposed. (ecco-ibd.eu)
  • We found that patients after induction chemotherapy plus G-CSF had similar overall survival (43% vs 40%, P = .88), event-free survival (37% vs 31%, P = .29), and relapse rates (34% vs 36%, P = .77) at 5 years as those not receiving G-CSF. (maastrichtuniversity.nl)
  • It accounts for 25 percent of all adult leukemias in the Western world and has one of the lowest survival rates of all leukemias. (pharmamanufacturing.com)
  • Both the duration of the survival time of this animal, which was that of 16 months, and the period of remission (29 cycles) of the neoplasia in the rescue protocol, had been superior to those found in available literature. (vin.com)
  • The primary study endpoint was 3-year event-free survival (EFS) following induction. (cancertherapyadvisor.com)
  • Secondary study endpoints included HCR, safety, and the efficacy of allo-HSCT (ie, relapse-free survival, relapse rate, and non-relapse mortality). (cancertherapyadvisor.com)
  • In their concluding remarks, the study authors noted that "this study demonstrated [dasatinib]-combined 2-step induction improved pretransplant treatment, which facilitated [allo-HSCT] and resulted in significantly improved survival. (cancertherapyadvisor.com)
  • The survival rate of children with ALL is nearly 90% 4 . (bvsalud.org)
  • The pCR rate was 10.3% (67/649), with a partial response in 35.9% (233/649) patients. (lu.se)
  • Rinvoq met its primary and key secondary endpoints with its 45-mg dose in the two induction studies, and with its 15-mg and 30-mg doses in the maintenance study. (biospace.com)
  • the median time from remission to relapse was 13 months and 15 months, respectively (P = 0.023, log rank test). (nih.gov)
  • At a median follow-up of 4 years, the rates of 3-year EFS and 3-year OS for the overall study group and the subgroup of those undergoing allo-HSCT were 66.2% and 80.5% compared with 74.1% and 84.1%, respectively. (cancertherapyadvisor.com)
  • Dose escalation (90mg 4 weekly) was administered to 13 patients (6.6%) during induction, 48 (42.1%) in maintenance, and 15 patients (13.2%) received IV re-induction during maintenance. (ecco-ibd.eu)
  • PHILADELPHIA, PENNSYLVANIA, October 9, 2018 - The Janssen Pharmaceutical Companies of Johnson & Johnson today announced new data showing treatment with a single intravenous (IV) dose of STELARA ® (ustekinumab) induces clinical remission and response in adults with moderate to severe ulcerative colitis (UC) who previously experienced an inadequate response or were intolerant to conventional or biologic therapies. (jnj.com)
  • Results from the induction phase of the Phase 3 UNIFI study show that treatment with a single IV dose of STELARA induced clinical remission in a significantly greater proportion of UC patients at week 8, compared with placebo, at both doses studied. (jnj.com)
  • Ustekinumab showed good drug sustainability and clinical efficacy in a population with severe disease phenotype and high rates of previous anti-TNF failure, however frequent and early dose intensification was required. (ecco-ibd.eu)
  • The patient should be observed closely for signs that the dose may need to be altered, such as changes in clinical status resulting from disease remissions or exacerbations. (who.int)
  • The significant rates of remission observed through the 8-week induction, coupled with a safety profile that is well-documented through years of research and use in other immune diseases, demonstrate the potential for ustekinumab as an effective treatment for UC. (jnj.com)
  • In CD patients, the clinical remission rates were not significantly different between the vedolizumab and ustekinumab groups (53.6% vs. 50.0%, p = 0.820). (biomedcentral.com)
  • Moreover, the cumulative rates of clinical relapse were not significantly different between the vedolizumab and tofacitinib groups in UC patients and between the vedolizumab and ustekinumab groups in CD patients ( p = 0.396 and p = 0.692, respectively). (biomedcentral.com)
  • The MTX regimen used in the present study was less effective for induction of remission in patients with extensive disease and pulmonary involvement and was associated with more relapses than the CYC regimen after termination of treatment. (nih.gov)
  • The traditional regimen for induction chemotherapy, irrespective of favorable intermediate or unfavorable-risk AML, is the 7+3 regimen. (pharmacytimes.com)
  • This analysis focused on the allo-HSCT-related end points in a study of patients with newly diagnosed Ph+ ALL treated with a 2-step dasatinib-containing induction regimen. (cancertherapyadvisor.com)
  • There are some chemical therapeutic protocols, which are divided into phases of induction of remission, intensification, maintenance, and rescue. (vin.com)
  • Clinical response and remission rates were 78.1% and 57.7% using CDAI, and 82.5% and 51.8% based on HBI scores after induction treatment (w8). (ecco-ibd.eu)
  • In the United States, before the combination of azacitidine and venetoclax was approved, people who were ineligible for induction chemotherapy-that is, they were too sick or past the age considered safe to receive it-often received azacitidine alone, with the goal of reducing the symptoms of leukemia and extending how long they lived. (cancer.gov)
  • Conclusion: Deep remission from induction CT was associated with favorable survivals in localized NKTCL receiving CT+RT, and an induction CT response-adapted individualized treatment strategy might be recommended in clinical practice. (aging-us.com)
  • Conclusion Cessation of infliximab was successful in 52%, with numerically higher success rates in patients initially treated with infliximab. (bmj.com)
  • CONCLUSION: The reported pCR rate of 10% highlights the potential for non-operative management in selected cases. (lu.se)
  • The maintenance phase evaluated the drug's ability to sustain remission and prevent relapse. (mountsinai.org)
  • Data from three trials supported the FDA's regulatory greenlight: the induction studies U-EXCEED and U-EXCEL, and the maintenance study U-ENDURE. (biospace.com)
  • Rinvoq likewise led to significantly better clinical remission rates, which ranged from 36% to 46% in the two induction studies and 18% to 23% in the maintenance study. (biospace.com)
  • Additionally, treatment recommendations are different for induction of remission and maintenance of remission. (medscape.com)
  • Future prospective studies are required to test different strategies that can improve the rates and quality (based on measurable residual disease [MRD] assessment) of remissions prior to and after allo-HCT using less toxic and more effective induction, conditioning, and maintenance therapies. (ascopost.com)
  • Results from open-label trials suggest that methotrexate (MTX) and leflunomide (LEF) are effective for maintenance of remission in Wegener's granulomatosis (WG), but data from randomized controlled clinical trails are not yet available. (uni-luebeck.de)
  • Lower maternal educational level was associated with increased frequency of mucositis, as were induction chemotherapy and maintenance chemotherapy after relapse. (bvsalud.org)
  • Rather, it is a clinical state that TNF- plays a pathogenic role in the characterized by heavy proteinuria and induction and/or maintenance of glomeru- hypoalbuminaemia, often associated with lar barrier dysfunction [ 8 ]. (who.int)
  • At 6 months, the remission rate in patients treated with MTX (89.8%) was not inferior to that in patients treated with CYC (93.5%) (P = 0.041). (nih.gov)
  • clinical relapse for people in remission, 3. (bvsalud.org)
  • If patients remain in remission after these treatment cycles, they will no longer receive treatment. (pharmacytimes.com)
  • In this retrospective analysis, the investigators assessed the impact of the number of induction and consolidation cycles and disease status on the success of allo-HCT in 3,113 patients with AML from 2008 to 2019. (ascopost.com)
  • Among the existing rescue protocols, D-MAC (dexamethasone, melphalan, actinomycin D and cytosine arabinoside) is of a lower toxicity, with an 80% remission rate, and its use is recommended in six to eight cycles. (vin.com)
  • 2019). Despite improved remission rates, the duration of response is still inadequate. (confex.com)
  • Only one new report from an original epidemiology study in relation to leukemia induction by formaldehyde has been published since the last review. (who.int)
  • Clinical assessments were performed at baseline study visit (SV) 1 and post-induction (SV2). (ecco-ibd.eu)
  • The high relapse rates in both treatment arms support the practice of continuation of immunosuppressive treatment beyond 12 months. (nih.gov)
  • Objective: We aimed to assess the association between induction chemotherapy (CT) response and survivals and to explore an induction CT response-adapted treatment strategy for localized extranodal NK/T-cell lymphoma (NKTCL) receiving first-line sequential CT and radiation (RT). (aging-us.com)
  • Existing treatment options often fall short in achieving sustained remission and controlling symptoms. (mountsinai.org)
  • Ulcerative colitis is a complex immune disease, and more than half of UC patients have not experienced remission with currently available conventional or biologic treatment options," said lead investigator Bruce E. Sands, MD, Dr. Burrill B. Crohn Professor of Medicine and Chief of the Dr. Henry D. Janowitz Division of Gastroenterology at the Icahn School of Medicine at Mount Sinai. (jnj.com)
  • In the past, the only aim of IBD treatment was to achieve and maintain clinical remission and a clinical response. (biomedcentral.com)
  • Treatment includes induction chemotherapy to achieve remission and postremission chemotherapy (with or without stem cell transplantation) to avoid relapse. (msdmanuals.com)
  • however, those with ECOG 3-4 at the time of COVID-19 diagnosis (77.5%) or with worsening of ECOG to 3-4 during COVID-19 (78%) had lower rates. (hematologyadvisor.com)
  • Based on overall response rate, the indication was approved under accelerated FDA approval. (wikipedia.org)
  • Responses after induction CT (initial response), RT (final response) and survivals were analyzed. (aging-us.com)
  • Clinical response and remission rates were determined using PRO2 definitions (STRIDE II guidelines). (ecco-ibd.eu)
  • Logistic regression analyses were performed to identify predictors of clinical response and remission. (ecco-ibd.eu)
  • Clinical response at SV4 (n=101) was associated with higher post-induction UST levels (p=0.03) (Table 1). (ecco-ibd.eu)
  • Despite the high efficacy of anti-TNF agents, approximately 10-40% of patients do not experience an improvement in clinical signs or symptoms after the induction phase, defined as a primary non-response [ 5 ]. (biomedcentral.com)
  • Early studies with induction including 6-mercatopurine (6-MP) alone or in combination with steroids, methyl-glyoxal guanyl hydrazine and/or methotrexate led to poor results. (nature.com)
  • In a large international study of people with this form of AML who can't have intensive chemotherapy , combining a drug called ivosidenib (Tibsovo) with the chemotherapy drug azacitidine was substantially more effective at producing remissions than azacitidine alone . (cancer.gov)
  • Patients with hematological malignancies and COVID-19 had a high mortality rate, according to the results of a study presented during the European Society of Medical Oncology (ESMO) Congress 2021. (hematologyadvisor.com)
  • A recent publication has demonstrated that introduction of NOS blockers in combination with chemotherapy led to slower leukemia progression and longer remissions in contrast to chemotherapy alone (Passaro et al, 2017). (confex.com)
  • Several possible mechanisms were considered for the induction of human leukemia, such as clastogenic damage to circulatory stem cells. (who.int)
  • Therefore, on the basis of the data available at this time, it was not possible to identify a mechanism for the induction of myeloid leukemia in humans. (who.int)
  • U-EXCEED had an additional 12-week open-label, active single-group induction period to allow for the accrual of enough patients for entry into U-ENDURE. (mountsinai.org)
  • Most patients (n=30) fulfilled criteria for sustained clinical remission by week 24. (medscape.com)
  • To determine the frequency and clinical characteristics of polymyalgia rheumatica (PMR) with low erythrocyte sedimentation rate (ESR) at diagnosis in a community based cohort of 232 patients. (nih.gov)
  • After medication administration, there was a decrease in pain and normalization of serum creatinine (0.50 mg / dL) and CRP (less than 6 mg / dL) and an increase in erythrocyte sedimentation rate (17 mm3). (bvsalud.org)
  • No increase was observed in the hematological disease relapse rate at Day 90 following COVID-19. (hematologyadvisor.com)
  • Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate. (medlineplus.gov)