Open [Tokyo, Japan] Study of the Efficacy and Safety for Rituximab in Myalgia Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

BTW I emailed the Japanese PIs a while ago to express my concerns about their trial, but of course never heard back.

Also now Nancy Klimas wants to do a rituximab trial on the “auto immune subset”

 
Also now Nancy Klimas wants to do a rituximab trial on the “auto immune subset”

That really is a bizarre et of statements reported by Cort Johnson. Including a suggestion that Travis Craddock studied EBV in B cells and epithelium. I know Travis well and he is a mathematician involved in computer modelling, not an immunologist. I don't know where the strange statements actually arise from but this makes no sense.

If people have viral reactivation the last thing you want to do is give them rituximab - they are likely to die. Unless of course the problem really is EBV, but we have pretty extensive negative data on that.
 
BTW I emailed the Japanese PIs a while ago to express my concerns about their trial, but of course never heard back.

Also now Nancy Klimas wants to do a rituximab trial on the “auto immune subset”


Her trial that is designed to cure ME/CFS that is apparently underway according to this article sounds utterly bizarre. I mean I'd love if it were to work but...
 
All those arguments might be relevant if we have reason to think that targeting B cells make sense in the first place. With major risks involved I find it hard to see how any of these approaches are justified at present.

You seem to have changed your tune somewhat on dara's possible efficacy, which iirc is anti cd38. Are you still sceptical of the cd19/20 drugs like those Schibenbogen is trying?
 
You seem to have changed your tune somewhat on dara's possible efficacy, which iirc is anti cd38. Are you still sceptical of the cd19/20 drugs like those Schibenbogen is trying?

I have shifted to thinking that there may be a coherent rationale for targeting plasma cells. But we still have pretty good evidence for targeting B cells being useless - which would include CD19/CD20 based approaches. But even for Daratumumab I have said that it may be a useful experiment that may even prove clinically worthwhile for some people but that I think it is pretty unlikely to be a viable treatment in the longer term and will have significant risks.
 
I have said that it may be a useful experiment that may even prove clinically worthwhile for some people but that I think it is pretty unlikely to be a viable treatment in the longer term and will have significant risks.

So you think it might lose efficacy with repeated doses? Or is it just that the risks are too high?

On a related note are the risks immunosuppresion? I know cyclo had a lot of risks but not as au fait with daras
 
So you think it might lose efficacy with repeated doses? Or is it just that the risks are too high?

On a related note are the risks immunosuppresion? I know cyclo had a lot of risks but not as au fait with daras

Mostly the long term risk of keeping someone hypogammaglobulinaemic. I don't think we know that much about long term risks of Dara but they are most likely to relate to low Ig levels.
 
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