"Rituxan: re-energizing CFS", SciBX, 10/27/11

[justinreilly]

Anyone have access to the full article?


http://www.nature.com/scibx/journal/v4/n42/full/scibx.2011.1167.html

SciBX 4(42); doi:10.1038/scibx.2011.1167
Published online Oct. 27 2011

Rituxan: re-energizing CFS
by Michael J. Haas, Senior Writer

Even as XMRV has been taken off the table as a cause of chronic fatigue syndrome, new research from Norway points to the condition as a B cell disorder and suggests the potential to repurpose Rituxan and other CD20 antibodies for CFS.

 

[oceanblue]

Sorry, no, but I'd love to read it too. There seem to have been quite a lot of coverage of CFS in nature journals recently - even if the coverage hasn't been to everyone's liking I think it's very positive the illness is getting exposure in such serious science mags.

 

[shannah]

Dr. Enlander just posted some encouraging news on his FB page.

"Dr David Bell and I will attempt to replicate the Rituximab study. David is enthusiastic in doing this as he retired from active practice and will come to New York to work with us in the new ME/CFS center."

 

[Battery Muncher]

Sounds fantastic! Does anyone know who else is trying to replicate the Rituximab study?

 

[FancyMyBlood]

Sounds fantastic! Does anyone know who else is trying to replicate the Rituximab study?

I think you're already aware, but the Norwegians themselves will do a large, multicenter phase III RCT.

 

[SpecialK82]

Outstanding! I wonder if the patient pays? I don't see how the center could afford it unless they have funding....maybe they do...

 

[searcher]

My understanding is that Dr. Kogelnik in the SF Bay Area has been trying to set up a rituximab trial for some time. I am not sure where he is in the approval process.

 

[Sing]

Will Dr. Bell and Dr. Enlander being doing their study at the new Mount Sinai center, to which I just heard an ME patient has donated a million dollars?

 

[oceanblue]

Finally got to read this short Science-Business eXchange article by Michael Haas.

It summarises the Fluge paper and looks at other commerical anti-CD20 monclonals that might have the same effect as rituximab (brand name Rituxan):
Ofatumumab, from Genmab/GlaxoSmithKline is already on the market, licenced for different illnesses. There are 2 other mabs in development (Phase III trials for other illnesses), both from the same Biotech/Gentech/Roche consortium that produce rituximab: Ocrelizumab and GA101.

What most interested me about the article was the additional information on the future planned studies by Mella and Fluge:

1. Open-label maintenance trial of rituximab in 27 of 30 patients from the recent study (presumably excluding the 3 patients that recovered). I don't think we knew previously which patients were in the planned open-label study. Mella said:

We think most patients will need more than just two infusions of rituximab to have a lasting effect."

2. A phase II trial of rituximab in patients with severe CFS.

3. Identification of an autoantibody marker for CFS, specifically ones that target nervous sensory proteins

A lot of the disease symptoms appear to be related to nervous system defects, Mella said. These patients are often hypersensitive to light and sound and have excessive muscular pain sensations without any obvious source or cause. Fluge said those symptoms suggest some nervous system filter is missing in CFS patients, resulting in massive sensory input.

They intend to search for proteins that might compose such a filter by testing plasma from patients and healthy controls against known nervous system proteins from humans and animals.

 

[sensing progress]

thanks for posting the update on the article oceanblue!

 

[Sing]

These drug names begin to remind me of West and Central African names. I know this comment is irrelevant. Yet, I would be interested in reading an article on drug names by a linguistics pro. Any takers?

 

[sensing progress]

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[Battery Muncher]

Good post Ocenblue! Will be interesting to see how the patients from the first trial fare on bigger doses (over longer period). I'm also delighted to hear Fluge and Mella's plans for finding autoantibody markers etc. Sounds like they have a good idea already!

 

[urbantravels]

All about mAbs - the naming convention always includes "mAb" for "monoclonal antibody." http://www.landesbioscience.com/journals/mabs/about/#background

 

[Sing]

Thanks, urbantravels. I glanced at the journal link you offered. It looks as though this is an exciting realm for research now which is attracting a lot of interest and probably funding. Let's hope that our "mAb" works out!

 

[urbantravels]

One take-home message is that there is a whole menu of other mAbs (and still more being developed.) Rituximab looks promising for us right now; but there are also other options to try if Rituximab doesn't pan out for all patients.

Rituximab just happens to be one of the mAbs that's been around longest and is one of the best-understood. (Yes, that includes possible side effects, some of them potentially very serious: but at least it's a 'devil you know' sort of situation - there's enough experience with the drug that they know what to watch out for, and in some cases can counteract the side effects.)