No improvement in chronic fatigue with new medicine
Researchers hoped they had found the first effective drug against CFS, but the patients ended up just as exhausted as before.
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Studies of potential new drugs are rarely published if they show no effect. But Vegard Bruun Wyller and his research group at the University of Oslo have published exactly this kind of study for a drug they tested for chronic fatigue syndrome (CFS).
Bruun Wyller's research assumes that patients with chronic fatigue syndrome have a sustained stress response in the body.
The researchers hoped that patients would experience fewer symptoms if they were given a drug called clonidine, which blocks the body's stress response and lowers heart rate and blood pressure.
The researchers believe several factors may contribute to a sustained stress response in the body, including long-lasting infections, dramatic life events and personality.
Significant loss of function
Bruun Wyller and his colleagues studied 120 adolescents between 12 and 18 years old.
In one part of the study, researchers compared patients with and without the illness. People with CFS walked less than half the number of steps per day as the healthy participants in the study, and they experienced a lot of fatigue.
The researchers also found that patients had greater difficulty sleeping, were more sensitive to sensory stimuli and had more symptoms of inflammation.
In summary, Bruun Wyller explains, “they had a significant over-representation of many different symptoms.”
No signs of Lyme disease
There has been a long-standing debate as to whether CFS and Lyme disease, which can be contracted from tick bites, are related.
Researchers at Rikshospitalet University Hospital have made microbiological studies of CFS patients, but found no traces of Lyme disease.
Treated with clonidine
In another part of the new study, researchers treated patients for eight weeks. Sixty young people received a placebo, or dummy treatment, while 60 received the drug clonidine.
The researchers hoped that clonidine would block stress responses in the body. The medication has both anti-inflammatory and hormonal effects.
According to Bruun Wyller, “much of the basic knowledge on this product indicates that it can help CFS patients.”
Negative and interesting
“However, the results were both interesting and somewhat depressing”, he says.
The medicine had no positive effect on the patients. Those who received clonidine did not, for example, walk more steps per day.
Clonidine had an effect on the stress response: It lowered adrenalin levels and inhibited inflammation in the body.
“This is interesting,” Bruun Wyller says. “We managed to normalize markers of disease activity, but still did not have any effect on the symptoms.”
Still a mystery
The problem with research into CFS is not that we know so little. The problem is that we do not understand how all the tings that we know are related, Bruun Wyller says.
He believes that it is absolutely necessary to have a more integrated model. Only then can researchers hope to make the pieces of this puzzle fit.
“To increase our understanding of the biology of CFS patients, we need to be able to put things together. We need to understand how different parts of the body interact," he says.
“We have come one step closer with this research. We still believe that the key is the sustained stress response in the patient. We have a lot of evidence of this phenomenon in patients. But there is no direct correlation between the stress response and the symptoms,” he added.
Can a cancer drug help?
At Haukeland University Hospital in Bergen another research group is testing the cancer drug Rituximab on CFS patients.
A pilot project on three patients and a clinical study on 30 patients have shown that Rituximab – which is an immune-regulating drug – gives a clear improvement in about two-thirds of patients.
The researchers believe that CFS is an immunological, probably autoimmune, disease. This means that the immune system does not recognize some of its own tissues, and produces antibodies to supress the supposed intruders. The body is in fact attacking itself.
Translated by: Lars Nygaard