Trial Report Antibody-mediated autoimmunity in symptom-based disorders: position statement and proceedings from an international workshop, 2024, Mountford et al

Free:
https://journals.lww.com/painrpts/f...mediated_autoimmunity_in_symptom_based.4.aspx

MEETING PROCEEDINGS
Antibody-mediated autoimmunity in symptom-based disorders: position statement and proceedings from an international workshop

Abstract

A 2-day closed workshop was held in Liverpool, United Kingdom, to discuss the results of research concerning symptom-based disorders (SBDs) caused by autoantibodies, share technical knowledge, and consider future plans. Twenty-two speakers and 14 additional participants attended.

This workshop set out to consolidate knowledge about the contribution of autoantibodies to SBDs.

Persuasive evidence for a causative role of autoantibodies in disease often derives from experimental “passive transfer” approaches, as first established in neurological research. Here, serum immunoglobulin (IgM or IgG) is purified from donated blood and transferred to rodents, either systemically or intrathecally.

Rodents are then assessed for the expression of phenotypes resembling the human condition; successful phenotype transfer is considered supportive of or proof for autoimmune pathology.

Workshop participants discussed passive transfer models and wider evidence for autoantibody contribution to a range of SBDs.

Clinical trials testing autoantibody reduction were presented.

Cornerstones of both experimental approaches and clinical trial parameters in this field were distilled and presented in this article.

Mounting evidence suggests that immunoglobulin transfer from patient donors often induces the respective SBD phenotype in rodents.

Understanding antibody binding epitopes and downstream mechanisms will require substantial research efforts, but treatments to reduce antibody titres can already now be evaluated.

 

I'm not familiar with the majority of authors. The list includes the well known Scheibenbogen, Goebel and Bevan and interestingly several representatives of pharmaceutical companies including one of Argenx who produces Efgartigimod currently being trialled in Long-Covid for the indication POTS.

In the short introduction amongst the SBD they mention fibromyalgia syndrome and POTS but not ME/CFS explicitly (even though it's implicitly included in "and others") and conclude that

I thought the following talks would have possibly had the most relevance for ME/CFS and LC:

A representative of Miltenyi Biotec, who from what I recall produce the Apheresis filters often used in Germany, presented some preliminary data on the use of Apheresis in LC.

Brit Adler held a talk on the role of autoantibodies in POTS and mentions ME/CFS.

Scheibenbogen held her usual talk on the possible role of GPCR-aabs and data from ongoing immunadsorption trials.

Stuart Bevan, working together with well known LC researchers (David Price, Helen Davis) discusses ongoing work in mice on LC.

The talk by Bashford-Rogers on B-cell selection looks like it could potentially be interesting.

Argenx presented a talk on their trial of an FcRn inhibitor in LC POTS.

Goebel presented a talk on on a randomised, controlled trial of Rozanolixizumab in fibromyalgia syndrome which looks potentially interesting as well with Rozanolixizumab being a competetior of Argenx. I had not been aware of this trial.

 

Just wanted to add:
The company behind the trial (UCB) has released some limited results:
"The phase 2a study with rozanolixizumab in severe fibromyalgia syndrome showed statistically significant superiority to placebo but did not meet predefined criteria for progression. [...] UCB decided not to pursue a Phase 3 program for rozanolixizumab in severe fibromyalgia and to terminate this program." [https://www.ucb.com/newsroom/press-...trong-launch-execution-driving-company-growth]

My interpretation:
Results were not good enough to justify investing in a Phase 3. A pity, since the results seem to be superior to placebo.
Though we need to wait for the paper, one should not be guessing based on a single sentence.

Goebel will report some results in April at a conference [https://efic2025.abstractserver.com/program/#/details/sessions/88] and according to private communication UCB aims to publish a paper later this year.

 

Probably missed this post last June.
I wondered if those asking Chatbots to illustrate the absurdities on Trish's word game thread could ask them to do a picture of 'distilled cornerstones'. It is a novel concept to me.

 

I think one will have to wait for the paper. Pharmacompanies tend to analyse results till something positive comes up and spin it that way in their press releases, so "superior to placebo" could just as well mean nothing.