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    Cancer Drug May Also Treat Chronic Fatigue Syndrome

    Rituximab Reduced Fatigue in 67% of Patients in Study
    WebMD Health News
    Reviewed by Laura J. Martin, MD

    Oct. 19, 2011 -- Researchers in Norway say they’ve been able to treat symptoms of chronic fatigue syndrome by giving patients a biologic drug that affects the immune system.

    The drug, rituximab (Rituxan), works by depleting immune cells called B-cells. It is FDA approved to treat non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, and two kinds of vasculitis.

    For the study, researchers recruited 30 people with chronic fatigue syndrome (CFS). Half got two infusions of rituximab given two weeks apart. The other half got infusions of saline solution as a placebo.

    Ten patients in the rituximab group (67%) and two patients in the placebo group (13%) saw at least moderate reductions in fatigue.

    In most of the patients, improvements were transient and faded within eight to 44 weeks.

    But three patients, two in the rituximab group and one that got the placebo, continue to be symptom free 2 1/2 years after their treatments. Those three patients have all returned to full-time jobs, researchers say.

    The study is published in the journal PLoS One.

    “Our thought is that in fact CFS is an autoimmune disease in most patients,” says study researcher Olav Mella, MD, PhD, an oncologist at Haukeland University Hospital in Bergen, Norway.

    Mella and his colleague, Oystein Fluge, MD, PhD, say they accidentally discovered that rituximab might help chronic fatigue syndrome after they used it to treat three patients who suffered from both CFS and non-Hodgkin’s lymphoma. All three patients reported significant improvements in fatigue after rituximab infusions. They eventually relapsed and were given more doses of rituximab. All three again had improvements in their CFS, though those eventually faded.

    Their cases were reported in BioMedCentral Neurology in 2009.

    Is Chronic Fatigue Syndrome an Autoimmune Disease?

    Researchers say they aren’t sure why the drug is working.

    “We cannot know for sure, but what we see is that there’s a delay from the rapid B-cell depletion after rituximab treatment to the clinical response. The delay can be from three to perhaps eight months before the response is thought to occur,” says Fluge, who is an oncologist and medical physicist at Haukeland Hospital.

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