Cancer Drug May Also Treat Chronic Fatigue Syndrome
Rituximab Reduced Fatigue in 67% of Patients in Study
Is Chronic Fatigue Syndrome an Autoimmune Disease? continued...
B-cells are part of the immune system. They roam the body in relatively small numbers searching for foreign invaders. When a B-cell finds one, it springs into action, becoming an infection-fighting chemical factory.
In some diseases, like leukemia, B-cells may go haywire and cause cancer. In rheumatoid arthritis, B-cells may attack the body's own tissues.
In CFS, however, it’s unclear why killing off B-cells might help.
One theory, held by researchers who believe CFS may be caused by an infection, suggests that retroviruses may hide out in dormant B-cells, only becoming active when the cell is triggered and rapidly multiplies.
But Fluge thinks if that’s the case, patients would see quicker improvements after taking the rituximab.
“We think what we see could be best explained with an autoimmune mechanism and gradual elimination of auto-antibodies,” he says.
Other, more circumstantial evidence supports the idea that CFS may be an autoimmune disease.
Like other autoimmune conditions, it tends to be much more common in women than in men, for example. Many people report getting CFS after a bout with triggering illness. The risk of getting chronic fatigue appears be similar to the risk for getting other kinds of immune disorders.
More Research Needed
Despite the positive results of the study, researchers stressed that it was far too early for people with chronic fatigue to seek treatment with rituximab.
“For the time being, this is a clinical trial. It is not for routine use. We need at least one more large study, partly here and partly somewhere else, to confirm the results,” Mella says.
Rituximab is expensive. A single course of treatment for cancer can cost more than $20,000. Rarely, fatal reactions have been reported after infusions of the drug, although no significant adverse events were reported in the current study.
“The most exciting news from the study is the possibility of disease-modifying treatment for at least some people with CFS,” Kim McCleary, president and chief executive officer of the CFIDS Association of America, says in an email. “This study also provides support for other possible approaches to repair immune abnormalities that have been identified in CFS patients.”