What about seminal studies on the horizon? Do we think the rituximab trial will be seminal?
Unless there is little to no effect, absolutely.
The rituximab trial is a double-blinded trial.
In principle, the Rituximab phase II trial could have been the most effective and powerful placebo trial ever conducted in CFS.
it was not blinded, and arguments could be made that this could also indicate that the response was a massive placebo response, and consistent with CBT results. (though much, much more effective).
The phase III trial doesn't suffer from this.
The patient doesn't know which treatment they're getting, it's a largish trial, and the response measures are allegedly significantly larger than have been seen by CBT.
This tells us:
It is not psychological, because there is no psychological component of the treatment.
It is not 'benefit seeking', as otherwise there would be no effect.
It is one disease that can be reliably selected by clinical criteria without need for a blood test.
There is hope for a treatment - even if rituximab isn't it for some reason.
Other treatment with tiny effect sized and moderate to considerable costs (CBT, ...) is much less effective. (arguably not effective, but that's a seperate argument).
If the effects are 'significant' (much larger than 1/7 patients more in the trial arm report 'better, or very much better at 12 weeks), or much better than 5-7% improvement by a tiny amount (GETSET and PACE 12months paper), we can almost stop hammering on those trials, as they are so ridiculously outclassed.
(of course, we absolutely should not stop hammering on these trials until at the least significant errors in the methodology are addressed through retraction, letters of concern by journal editors, or the global understanding in every nation that these are not useful approaches)