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The Norwegian trial has money but is still short ten million dollars last I read.
Ouch. I can understand funders being hesitant to put that sort of money up. Maybe we need a couple more smaller trials at different centres first?
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The Norwegian trial has money but is still short ten million dollars last I read.
I believe that the expiration date on the patent varies by country.The good news is that Rituximab comes to the end of its patent in about a years time, if I remember correctly, so there should be cheaper generic versions available.
Conclusion
The delayed responses starting from 2–7 months after Rituximab treatment, in spite of rapid B-cell depletion, suggests that CFS is an autoimmune disease and may be consistent with the gradual elimination of autoantibodies preceding clinical responses. The present findings will impact future research efforts in CFS.
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0026358
The B-cells have multiple immune functions, the main ones being antibody production, antigen presentation and regulation of the function and activity of other immune cells, i.e. T-regulatory cells, NK cells and macrophages [16]. Thus, the total effects of B-cell depletion on the immune system are likely to be complex and time-dependent.
In Stiff Person Syndrome, which is a rare autoimmune disease in the central nervous system with autoantibodies targeting glutamic acid decarboxylase (GAD65), the humoral autoimmune response was shown to consist of a Rituximab-sensitive part rapidly cleared after treatment, and a Rituximab-resistant part from long-lived and persistent plasma cells acting as a reservoir for secretion of autoantibodies. This may be one mechanism for lack of effect from B-cell depletion therapy [17].
An alternative explanation for the observed clinical improvement from B-cell depletion could be elimination or reduction of B-lymphotrophic viruses such as cytomegalovirus (CMV) or Epstein-Barr virus (EBV). A recent study [18] showed clinical benefit from long-term valacyclovir or valgancicliovir treatment in a subset of CFS patients with evidence of active on-going herpes virus infections, also shown in a previous small study of 12 patients with elevated antibodies to EBV or human herpes virus 6 (HHV-6) [19]. We find the delayed clinical responses after B-cell depletion, that we observed in the majority of responders, difficult to explain from a viral elimination mechanism. In our opinion, this response pattern is more compatible with the gradual elimination of an autoantibody, perhaps by preferential elimination of short-lived pre-plasma cells. Although poorly understood, immune system alterations seen in stress-related diseases such as post-traumatic stress disorder could also be relevant for the effects of B-cell depletion seen in CFS [20].
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0026358
The good news is that Rituximab comes to the end of its patent in about a years time, if I remember correctly, so there should be cheaper generic versions available.
Regarding the expense of rituximab, I just wanted to add: When I was treated for breast cancer, I had a tremendous improvement in the weakness/fatigue component of my CFS. I remember looking at my bills and noticing that one of the drugs they used in treatment was very expensive ($3000 per dose), but one was very cheap ( $10 per dose ). So, my point is that there are probably other drugs that can provide the same beneficial effects as rituximab....we just need to find out which ones. It is frustrating that both my CFS doctor AND the oncology nurses commented that CFS patients being treated for cancer often get better - I think we have known this for quite a while. Perhaps progress would be quicker if we can find a cheaper drug to use.
I will ask Dr. K when I go back in 2 weeks. I seem to be getting a very fast response. I slept for 12 straight hours last night and have felt a "shift" take place in my body. Hard to explain. I just feel less "fluish
" but time will tell. When I go back I am gonna ask Dr. K if he would be willing to get on here and answer the scientific questions... Worth a try anyhow???