Fatigatio meeting Sept 9–livestream from Germany

https://www.fatigatio.de/aktuelles/...lse-fuer-versorgung-forschung-und-aufklaerung

 

https://twitter.com/user/status/1699514401663926391


International professional conference on #MECFS and #LongCOVID to mark the 30th anniversary of @FatigatioeV!

09/9/2023 9:00 AM CEST - 5:15 PM CEST Livestream on YouTube: https://buff.ly/3L4o81F

 

https://twitter.com/user/status/1701009141198930418


Here is a link to Ron Davis talk at Berlin conference last Saturday. https://icloud.com/attachment/?u=https%3A%2F%2Fcvws.icloud-content.com%2FB%2FAd0Qp2eebsOI0WQu6oLlth0KewrjAYT1_MkdDSETk2o0wwtzpfnTh_7J%2F%24%7Bf%7D%3Fo%3DAjkpnXgukEUs-S_TPgRHJi-BNsbE8e7H2vLhWAbOUkRx%26v%3D1%26x%3D3%26a%3DCAog3Wl38jmiFgZpZ4cIwE_hY2GS_Fq3IAszybLeK0u0b30SdBDTqKHBpTEY07icla8xIgEAKgkC6AMA_wdhPVBSBAp7CuNaBNOH_slqJAerlGYBXyG0SB1WLwjCGhLBo_GgUQEZS4tXueT-CBZlynX1ynIkyQLQlnrZrkQzFsP2buTWCFmyFje7hhj_s44Pth65iUipbm9w%26e%3D1696288152%26fl%3D%26r%3DE3B07A1B-41B0-4453-903F-07080FCF3B5D-1%26k%3D%24%7Buk%7D%26ckc%3Dcom.apple.largeattachment%26ckz%3D8712C54D-0F56-4DC2-842B-AB128D06ABA1%26p%3D164%26s%3DP0h0WnSzF3KJpF0VucmPZZEuXv4&uk=F2YxEu_Cybca3rqpxW2zIw&f=Berlin%20Talk.mp4&sz=39780114

 

Talks about 2 possible ways to block(?) the Itaconate shunt if I'm correctly. One is blocking CAD for which there currently isn't a known drug, researchers at Utah are working on this apparently. I saw Janet Dafoe post that they found something last week I think, something they now want to trial.

The other way is blocking production of interferon alpha which could be done by JAK-stat inhibitors. Davis shares a story about a patient that said he got cured that way but says it wasn't document by a doctor, others say it didn't help them. One JAK-stat inhibitor I know is currently being tested by De Meirleir is filgotinib, which seems to have a good safety profile. I haven't read any updates on that though.

 

Not sure where the Etidronate fits in here—guess it’s not a CAD inhibitor.

 

Maybe it inhibits expression of ACOD1….which is different (I think).

ETA
Nope—it’s the same

 

Wes Ely has applied to study Baricitinib in LC.

https://www.youtube.com/watch?v=GYi9NJelm2A

Baricitinib as the treatment of choice for hospitalised individuals with COVID-19 (2022, Lancet: eClinicalMedicine)

The AI-Assisted Identification and Clinical Efficacy of Baricitinib in the Treatment of COVID-19 (2022, Vaccines)

Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 COV-BARRIER: a randomised, double-blind, parallel-group, placebo-controlled phase 3 trial (2021, The Lancet. Respiratory medicine)

Efficacy and safety of baricitinib plus standard of care for the treatment of critically ill hospitalised adults with COVID-19 on invasive mechanical ventilation or extracorporeal membrane oxygenation: an exploratory, randomised, placebo-controlled trial (2022, The Lancet Respiratory Medicine)

See also —

Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19 (2020, New England Journal of Medicine)
Baricitinib therapy in COVID-19: A pilot study on safety and clinical impact (2020, Journal of Infection)

 

Interesting that he mentions 6 months for the trial, then apparently a follow-up at 12 months. I think the idea for filgotinib was also to administer it for 6 months.

 

Do we know why in particular they chose Baricitinib versus other approved JAK drugs?

 

It was the "computer's top pick" for acute Covid. Whether this theoretically translates to utility in the Long Covid scenario is uncertain (it sounds like this RCT will go ahead though so we'll find out). It might be argued that severe acute Covid and Long Covid are at opposite ends of a spectrum or at least quite different mechanistically. Esp as they describe this being directed to the "cytokine storm" of severe acute disease.

From The AI-Assisted Identification and Clinical Efficacy of Baricitinib in the Treatment of COVID-19 (2022, Vaccines) —

 

From Epigenetic memory of coronavirus infection in innate immune cells and their progenitors (2023, Cell) —

I don't know whether the indicated benefit of targeting IL-6 is only in the acute phase or might show benefits in established LC.

 

@Jonathan Edwards

Could you please give your opinion on the potential use of Baricitinib (as well as fedratinib and ruxolitinib) to treat MECFS. Please see above discussion. As @SNT Gatchaman mentions these drugs might be more appropriate for acute Covid rather than LC MECFS. Thank you.

 

I don't seat likely to do anything in ME. Corticosteroids tend to shut off these pathways and dexamethasone is good in acute Covid. Butsteroids are not useful ME longterm.