Journal
CLINICAL THERAPEUTICS
Volume 41, Issue 5, Pages 798-805Publisher
ELSEVIER
DOI: 10.1016/j.clinthera.2019.02.011
Keywords
ME/CFS; clinical trials; immune therapy; illness heterogeneity; precision medicine
Categories
Funding
- National Institutes of Health [R01 NS090200-01, R56 AI065723-06A1, R01AR057853-01]
- US Department of Defense Congressionally Directed Medical Research Program [GW140142, GW093042]
- CDMRP [GW093042, 545856, GW140142, 793892] Funding Source: Federal RePORTER
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Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disorder characterized by prolonged periods of fatigue, chronic pain, depression, and a complex constellation of other symptoms. Currently, ME/CFS has no known cause, nor are the mechanisms of illness well understood. Therefore, with few exceptions, attempts to treat ME/CFS have been directed mainly toward symptom management. These treatments include antivirals, pain relievers, antidepressants, and oncologic agents as well as other single-intervention treatments. Results of these trials have been largely inconclusive and, in some cases, contradictory. Contributing factors include a lack of well-designed and-executed studies and the highly heterogeneous nature of ME/CFS, which has made a single etiology difficult to define. Because the majority of single-intervention treatments have shown little efficacy, it may instead be beneficial to explore broader-acting combination therapies in which a more focused precision-medicine approach is supported by a systems-level analysis of endocrine and immune co-regulation. (C) 2019 Elsevier Inc. All rights reserved.
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