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Treatment of 741 Italian Patients with Chronic Fatigue Syndrome

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By U. Tirelli et al. • • November 23, 2013

Editor's Comment: This study compared different treatments for patients diagnosed with CFS (Fukuda criteria). What is interesting about the patient cohort is that 40% of the male patients and more than half of the female patients presented with fever. (Pain and fever were the two predominant symptoms for the entire group.) Given the fact that all of the patients had contracted CFS after an initial infection, and that they still presented with infection-type symptoms (fever, sore throat, swollen glands), it is not surprising that treatment with antivirals and immunoglobulins were proven effective.

Note: You can read the full text of this study HERE.

BACKGROUND: Chronic Fatigue Syndrome (CFS) is a distinctive syndrome characterized by specific symptoms cluster. CFS mostly affects women and often results in severe functional limitation. Its prevalence varies from 0.4 to 2.5% in the general population. In our prior studies on the clinical features of 205 CFS patients we founded immunological and brain abnormalities. In this paper we illustrate our caseload on CFS treatment.

PATIENTS AND METHODS: From January 2000 to December 2005, we evaluated all the patients admitted at the CFS Unit of the Aviano National Cancer Institute, for staging procedures and treatments. Patients not meeting the Fukuda diagnostic criteria were excluded.

RESULTS: 250 male and 491 female (median age 35.5 and 39.3 years, respectively) were enrolled and treated for CFS. As expected, CFS resulted from previous infectious disease in all patients. Female patients showed to be more affected by symptoms than male patients. The treatment schedules followed by the patients included nutritional supplements alone, corticosteroids, antidepressant/sedative drugs, and antiviral/immunoglobulin drugs. Antiviral/ immunoglobulin drugs achieved the best response (15.3% positive responses vs. 8.3% negative responses; OR 0.44, CI 0.26-0.74, p = 0.002). The carrying out of 4 or more treatments showed a protective effect (OR 0.46, CI 0.28-0.77, p = 0.003). This finding was confirmed in the multivariate analysis, adjusted by type of drugs (OR 0.49, CI 0.28-0.84, p = 0.009) and number of treatments carried out (OR 0.51, CI 0.30-0.86, p = 0.01); these two variables were independent.

CONCLUSIONS: These findings show that the antiviral/immunoglobulin approach has a longer positive disease free survival in comparison with other approaches. However, CFS still remains a difficult disease to be effectively treated.

SourceEur Rev Med Pharmacol Sci 2013; 17 (21): 2847-2852. U. Tirelli, A. Lleshi, M. Berretta, M. Spina, R. Talamini, A. Giacalone.

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