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

Dolphin

Senior Member (Voting Rights)
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

Mountford, Rebeccaa,*; Adler, Brittany L.b; Andersson, Davidc; Bashford-Rogers, Rachaeld; Berwick, Richarda,c; Bevan, Stuartc; Caro, Xaviere; Chung, Tae Hwanf,g; Clark, J. Davidh; Dawes, John M.i; Dong, Xinzhongj; Helyes, Zsuzsannak,l,m; Kingery, Waden; van Middendorp, Joost J.o; Neiland, Harveya; Maurer, Margotc; Scheibenbogen, Carmenp; Schmack, Katharinaq,r; Schreiner, Thomass; Svensson, Camilla I.t; Tékus, Valériak,u; Goebel, Andreasa,v

Author Information
aPain Research Institute, University of Liverpool, Liverpool, United Kingdom

bDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, USA

cWolfson SPaRC, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom

dDepartment of Biochemistry, University of Oxford, Oxford, United Kingdom

eSouthern California Fibromyalgia Research & Treatment Centre, Northridge Hospital Medical Center Professional Building, Los Angeles, CA, USA

fDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

gDepartment of Neurology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA

hDepartment of Anesthesia, Stanford University School of Medicine, Redwood City, CA, USA

iNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom

jSolomon H. Snyder Department of Neuroscience, John Hopkins University School of Medicine, Baltimore, MD, USA

kDepartment of Pharmacology and Pharmacotherapy, Medial School, University of Pécs, Pécs, Hungary

lHUNREN-PTE Chronic Pain Research Group, University of Pécs, Pécs, Hungary

mPharmInVivo Ltd., Pécs, Hungary

nPalo Alto Veterans Institute for Research, Palo Alto, CA, USA

oArgenx, Ghent, Belgium

pInstitute of Medical Immunology, Charité—Universitätsmedizin Berlin, Berlin Institute of Health, Berlin, Germany

qFrancis Crick Institute, London, United Kingdom

rDivision of Psychiatry, University College London, London, United Kingdom

sMiltenyi Biotec, Bergisch Gladbach, Germany

tDepartment of Physiology and Pharmacology, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

uDepartment of Laboratory Diagnostics, University of Pécs, Pécs, Hungary

vWalton Centre NHS Foundation Trust, Liverpool, United Kingdom

*Corresponding author. Address: Pain Research Institute, University of Liverpool, Liverpool, L9 7AL United Kingdom. Tel.: 0151 529 5835. E-mail address: r.mountford@liverpool.ac.uk (R. Mountford).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0 (CC BY-ND) which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.

PAIN Reports 9(4):p e1167, August 2024. | DOI: 10.1097/PR9.0000000000001167
  • OPEN
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.

 
Last edited:
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

Increasing evidence indicates that, in addition to infection, triggers for SBDs can include toxicity such as after fluoroquinolone use9 and the experience of psychological trauma and distress.49

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

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.
 
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.

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.
 
Back
Top Bottom