B-cell Depletion Using the Monoclonal Anti-CD20 Antibody Rituximab in Chronic Fatigue Syndrome
Study Details
Study Description
Brief Summary
Based on pilot patient observations, and experience from the prior study KTS-1-2008, the investigators anticipate that chronic fatigue syndrome patients may benefit from B-cell depletion therapy using Rituximab induction with maintenance treatment.
The hypothesis is that at least a subset of CFS patients have an activated immune system involving B-lymphocytes, and that prolonged B-cell depletion may alleviate symptoms.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 2 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Rituximab Rituximab induction using two infusions (500mg/m2, max 1000 mg) two weeks apart, followed by maintenance Rituximab infusions (500 mg/m2, max 1000 mg) after 3, 6, 10 and 15 months. |
Drug: Rituximab
Two infusions of Rituximab 500 mg/m2 (max 1000 mg) given two weeks apart, followed by maintenance Rituximab infusions 500 mg/m2 (max 1000 mg) at 3, 6, 10, and 15 months.
Approved amendment: for patients with gradual improvement in CFS/ME symptoms after 12 months follow-up, but not having reached a clear response, up to 6 additional Rituximab infusions (500 mg/m2, max 1000 mg) may be given during the following 12 months period.
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Outcome Measures
Primary Outcome Measures
- Symptom alleviation, as compared to baseline, measured by standardized self-reports and quality of life schemes. [Major response of at least six weeks duration, independent on when occuring, during the follow-up period.]
The primary endpoint is defined as major response of the CFS symptoms, of at least six weeks duration, independent on when during 36 months follow-up the response period(s) occurs. Single such response periods, and the sum of these, are recorded.
Secondary Outcome Measures
- Symptom alleviation, as compared to baseline, measured by standardized self-reports and quality of life schemes. [At 3, 6, 10, 15, 20, 24, 30, 36 months after intervention]
The secondary outcome measures are effect on the CFS symptoms, by evaluation at 3, 6, 10, 15, 20, 24, 30, and 36 months after first intervention (i.e. first Rituximab infusion)
Eligibility Criteria
Criteria
Inclusion Criteria:
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patients with CFS
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age 18-66 years
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informed consent
Exclusion Criteria:
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patients with fatigue, not fulfilling criteria for CFS
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pregnancy or lactation
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previous malignant disease except basal cell carcinoma of skin and cervical carcinoma in situ
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previous major immunological disease, except autoimmune diseases such as diabetes mellitus or thyroiditis
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previous long-term use of immunosuppressive drugs, except steroids e.g. in obstructive lunge disease
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endogenous depression
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lack of ability to comply by the protocol
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multi-allergy with risk of serious drug reaction
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reduced renal function (creatinin > 1.5 x UNL)
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reduced liver function (bilirubin or transaminases > 1.5 x UNL)
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HIV positivity
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evidence of clinically significant infection
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Department of Oncology, Haukeland University Hospital | Bergen | Norway | N-5021 |
Sponsors and Collaborators
- Haukeland University Hospital
Investigators
- Principal Investigator: Olav Mella, PhD, MD, Haukeland University Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- 2010/1318