Drug research story, Daily Mail

June 6, 2007

Daily Mail – June 6

Could these new drugs end the misery of chronic fatigue?

by Roger Dobson

Tests are under way on three drugs that could help sufferers of Chronic Fatigue Syndrome.

A team of researchers will also investigate whether a virus is responsible for the condition, for which there is currently no diagnostic test or cure.

Chronic Fatigue Syndrome, once considered a condition whose symptoms were all in the mind, is now regarded by many doctors as a distinct disease with physical symptoms.

It is still poorly understood and can be disabling. Symptoms can include problems with concentration and short-term memory, as well as sleep disturbances, muscle pain and lack of energy.

It is most commonly found in young adults aged 30 to 40, but just how many people are affected is unclear because many cases are never diagnosed. Estimates vary widely, from 0.01 to 3 per cent of adults.

The cause is unknown, although some people seem to develop symptoms after an infection, and while there are some treatments for specific symptoms, including painkillers, recovery may take months or years.

Early pilot studies have shown that one of the drugs, an antiviral treatment due to begin a clinical trial next month, had a big effect on symptoms.

Patients infected with a herpes virus and Epstein-Barr virus, who had been suffering from excessive fatigue for at least a year, experienced significant improvements when given the antiviral drug valganciclovir.

All the patients had been infected for several years, and one theory is that the infections had impaired the immune system.

‘We were surprised to see a dramatic recovery,' say the researchers at Stanford University in the U.S., who found that patients' energy levels went up from 10 per cent to 90 per cent.

They have already used valganciclovir on 30 patients and have found that the drug works for people who have antibodies to the two viruses. Antibody levels in the blood are evidence of the body's past exposure to something that the body does not recognise as belonging to itself, such as a virus.

The researchers say that of the 26 patients with high levels of antibodies, 25 had a dramatic recovery. None of the other four responded to the treatment. In the new trial, patients will get the drug or placebo for a period of six months.

In a second trial, at the University of Cincinnati, the drug duloxetine, an antidepressant, is being given to patients with the condition to reduce symptoms.

The researchers say patients with the syndrome often also suffer from fibromyalgia – symptoms include chronic widespread pain, tenderness, fatigue, sleep and mood disturbances.

As many as seven out of 10 patients with fibromyalgia also meet criteria for Chronic Fatigue Syndrome.

Researchers say the two conditions may respond to the same treatment. ‘Like fibromyalgia, chronic fatigue is associated with chronic pain, sleep and mood disturbances.

‘Because fibromyalgia responds to treatment with antidepressants, including duloxetine, trials for chronic fatigue syndrome are clearly needed.'

A third drug, Ampligen, another antiviral, is undergoing two clinical trials for the condition. Results from an early study show that patients had reduced symptoms and needed less medication compared to those taking the placebo.

Meanwhile, researchers at Mississippi University are investigating whether the Epstein-Barr virus is involved in the condition.

The researchers, who are taking blood samples from around 150 people, with and without chronic fatigue syndrome, say the virus – a member of the herpes family and one of the most common viruses – may have the ability to affect the immune system and cause the symptoms of chronic fatigue."

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