Who is more likely to gain improvements/remission from Rituximab?

[Hip]

Found that information in the "Purpose" section of this current Rituximab trial study record detail: https://clinicaltrials.gov/ct2/show/NCT02229942

Thanks. That's the currently ongoing Fluge and Mella phase III clinical trial of rituximab for ME/CFS. It says:

The hypothesis is that a subgroup of patients with Chronic Fatigue Syndrome/ Myalgic Encephalopathy (CFS/ME) have a chronically activated immune system and may benefit from B-lymphocyte treatment using the monoclonal anti-CD20 antibody rituximab with induction and maintenance treatment.

I would guess that when Fluge and Mella refer to a "chronically activated immune system," they mean the idea that ME/CFS is driven by some ongoing but unknown immune process (which could be an autoimmune process).

 

[Forbin]

Well, the Columbia press release following the 2015 Hornig/Lipkin cytokine study certainly sounds like they are positing something akin to a "chronically activated immune system," and that it eventually reaches a point of immune "exhaustion."

STUCK IN HIGH GEAR

The study supports the idea that ME/CFS may reflect an infectious “hit-and-run” event. Patients often report getting sick, sometimes from something as common as infectious mononucleosis (Epstein-Barr virus), and never fully recover. The new research suggests that these infections throw a wrench in the immune system’s ability to quiet itself after the acute infection, to return to a homeostatic balance; the immune response becomes like a car stuck in high gear. “It appears that ME/CFS patients are flush with cytokines until around the three-year mark, at which point the immune system shows evidence of exhaustion and cytokine levels drop,” says Dr. Hornig. “Early diagnosis may provide unique opportunities for treatment that likely differ from those that would be appropriate in later phases of the illness.”

https://www.mailman.columbia.edu/pu...-evidence-chronic-fatigue-syndrome-biological