Developing curative therapies for Post-COVID and ME/CFS
Prof Carmen Scheibenbogen and German colleagues believe there is a need to explore treatments for ME/CFS and long COVID even though research hasn’t yet uncovered the full cause/s of the conditions and reliable diagnostic tests.
They have produced a list of drugs they believe are worth evaluating but only on strict subgroups of patients, defined by the WHO for PCS and the Canadian criteria for ME/CFS, using a consistent process.
“Our concept of a multipronged clinical trial platform approach addresses the complexity and heterogeneity of PCS and ME/CFS, enabling to test numerous drugs in clinical trials in a harmonized manner accompanied by comprehensive mechanistic studies. Such an approach will pave the way for more rapid development of drugs for PCS and ME/CFS to find therapeutic solutions for specific subgroups and finally all patients.
Further, it will allow the development and identification of precise diagnostic, prognostic and companion biomarkers ultimately leading to targeted and individualized therapies combatting the different disease mechanisms. Finally, the identification of biomarkers predicting response to treatment provides strong evidence for causative pathomechanisms.”
Fighting Post-COVID and ME/CFS – development of curative therapies, by Carmen Scheibenbogen, Judith T Bellmann-Strobl, Cornelia Heindrich, Kirsten Wittke, Elisa Stein, Christiana Franke, Harald Prüss, Hannah Preßler, Marie-Luise Machule, Heinrich Audebert, Carsten Finke5, Hanna G Zimmerman, Birgit Sawitzki, Christian Meisel, Markus Tölle, Anne Krüger, Anna C Aschenbrenner, Joachim L Schultz, Marc D. Beyer, Markus Ralser, Michael Mülleder, Leif E Sander, Frank Konietschke, Friedemann Paul, Silvia Stojanov, Lisa Bruckert, Dennis M Hedderich, Franziska Knolle, Gabriela Riemekasten, Maria J Vehreschild, Oliver A Cornely, Uta Behrends and Susen Burock, in Frontiers in Medicine, Sec. Infectious Diseases: Pathogenesis and Therapy: Vol 10, 15 Jun 2023 [doi.org/10.3389/fmed.2023.1194754]
Research abstract:
The sequela of COVID-19 include a broad spectrum of symptoms that fall under the umbrella term post-COVID-19 condition or syndrome (PCS). Immune dysregulation, autoimmunity, endothelial dysfunction, viral persistence, and viral reactivation have been identified as potential mechanisms. However, there is heterogeneity in expression of biomarkers, and it is unknown yet whether these distinguish different clinical subgroups of PCS.
There is an overlap of symptoms and pathomechanisms of PCS with postinfectious myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
No curative therapies are available for neither ME/CFS nor PCS. The mechanisms identified so far provide targets for therapeutic interventions. To accelerate the development of therapies, we propose evaluating drugs targeting different mechanisms in clinical trial networks using harmonized diagnostic and outcome criteria and subgrouping patients based on a thorough clinical profiling including a comprehensive diagnostic and biomarker phenotyping.
