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Approximately 900 adult participants were enrolled across six randomized, double-blind, placebo-controlled clinical trials conducted between 2001 and 2006
On the other hand, the evaluated population was based on European centers only, which limits the confidence for extrapolation to other cohorts, because SCA3 patients show high clinical heterogeneity [245]
But for many patients, the true driver of persistent pain may be something deeper: immune dysfunction and chronic inflammation
Thicker needles (29 gauge) draw and inject faster but may cause slightly more discomfort at the injection site
Reasonable candidates include: Mild to moderate IBD as an adjunct (never as sole therapy, always with GI oversight) IBS with a documented inflammatory component Post-infectious gut dysfunction where both tissue damage and persistent low-grade inflammation are present Mixed presentations, heartburn plus intestinal sensitivity plus food reactivity, where the clinical picture suggests multiple mechanisms Where this falls apart is when people treat it as a silver bullet
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