Rituximab and immune system "resetting"

Inspired by friend and fellow blogger Rambler, I'm getting back to doing some blog posts.

The big exciting news in ME/CFS is coming courtesy of two doctors in Norway: in a 30 person placebo-controlled double-blinded Phase II study, the monoclonal antibody drug Rituximab (trade name Rituxin in the US) was much more effective than placebo in treating ME/CFS. Some patients even went into remission and have remained in full health since undergoing treatment. Here is a interview with the two doctors in question and a young Norwegian woman, previously bedbound, and now fully healthy.

This is big news because there are no effective treatments for ME/CFS. There are some palliative band aids that address individual symptoms, but nothing that makes a significant difference in quality of life. In addition to being a possible treatment (follow-up independent confirmation of the results needs to happen before it becomes a regular treatment option outside of research studies), the effectiveness of this drug may lead to a better understanding of the disease etiology.

Rituximab destroys a part of the body's immune system called B lymphocytes or B cells, so they may be a key player in the pathogenesis of the disease. Through that mechanism could it be that Rituximab causes the immune system to reset itself and that in doing so an underlying disease process is disrupted, allowing the body to heal? An interesting article discusses just that possibility. It goes into how its effectiveness in treating another illness, Rheumatoid Arthritis, was discovered, and why it may work via an immune system "reset".

It should be pointed out the Rituximab was originally developed as a cancer drug to treat lymphomas and comes with potentially serious side effects. Also, like many other cancer drugs, the cost is prohibitively high and may well be unaffordable without insurance coverage (on the order of several thousand dollars for one infusion). An interview with a well known oncologist at the Cleveland Clinic covers some of the basics.

I would like to thank the two oncologists at Haukeland University Hospital in Norway for undertaking this study that has the potential to help maybe millions of people afflicted with ME/CFS.