{"id":12097,"date":"2017-03-08T08:37:14","date_gmt":"2017-03-08T08:37:14","guid":{"rendered":"http:\/\/wames.org.uk\/cms-english\/?p=12097"},"modified":"2017-03-08T08:37:14","modified_gmt":"2017-03-08T08:37:14","slug":"cytokine-inhibition-in-cfs","status":"publish","type":"post","link":"https:\/\/wames.org.uk\/cms-english\/cytokine-inhibition-in-cfs\/","title":{"rendered":"Cytokine inhibition in CFS"},"content":{"rendered":"<p><strong>Research abstract:<\/strong><\/p>\n<p>Background:<\/p>\n<p><a href=\"https:\/\/en.wikipedia.org\/wiki\/Interleukin-1_family\" target=\"_blank\">Interleukin-1<\/a> (IL-1), an important proinflammatory cytokine, is suspected to play a role in chronic fatigue syndrome (CFS).<\/p>\n<p>Objective:<\/p>\n<p>To evaluate the effect of subcutaneous <a href=\"https:\/\/en.wikipedia.org\/wiki\/Anakinra\" target=\"_blank\">anakinra<\/a> versus placebo on fatigue severity in female patients with CFS.<\/p>\n<p>Design:<\/p>\n<p>Randomized, placebo-controlled trial from July 2014 to May 2016. Patients, providers, and researchers were blinded to treatment assignment. (<a href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02108210\" target=\"_blank\">ClinicalTrials.gov: NCT02108210<\/a>)<\/p>\n<p>Setting:<\/p>\n<p>University hospital in the Netherlands.<\/p>\n<p>Patients:<\/p>\n<p>50 women aged 18 to 59 years with CFS and severe fatigue leading to functional impairment.<\/p>\n<p>Intervention:<\/p>\n<p>Participants were randomly assigned to daily subcutaneous anakinra, 100 mg (n = 25), or placebo (n = 25) for 4 weeks and were followed for an additional 20 weeks after treatment (n = 50).<\/p>\n<p>Measurements:<\/p>\n<p>The primary outcome was fatigue severity, measured by the Checklist Individual Strength subscale (CIS-fatigue) at 4 weeks.<\/p>\n<p>Secondary outcomes were level of impairment, physical and social functioning, psychological distress, and pain severity at 4 and 24 weeks.<\/p>\n<p>Results:<\/p>\n<p>At 4 weeks, 8% (2 of 25) of anakinra recipients and 20% (5 of 25) of placebo recipients reached a fatigue level within the range reported by healthy persons. There were no clinically important or statistically significant differences between groups in CIS-fatigue score at 4 weeks (mean difference, 1.5 points [95% CI, \u22124.1 to 7.2 points]) or the end of follow-up. No statistically significant between-group differences were seen for any secondary outcome at 4 weeks or the end of follow-up. One patient in the anakinra group discontinued treatment because of an adverse event. Patients in the anakinra group had more injection site reactions (68% [17 of 25] vs. 4% [1 of 25]).<\/p>\n<p>Limitation:<\/p>\n<p>Small sample size and wide variability in symptom duration; inclusion was not limited to patients with postinfectious symptoms.<\/p>\n<p>Conclusion:<\/p>\n<p>Peripheral IL-1 inhibition using anakinra for 4 weeks does not result in a clinically significant reduction in fatigue severity in women with CFS and severe fatigue.<\/p>\n<p>Primary Funding Source:<\/p>\n<p>Interleukin Foundation and an independent donor who wishes to remain anonymous.<\/p>\n<p><a href=\"http:\/\/annals.org\/aim\/article\/2607809\/cytokine-inhibition-patients-chronic-fatigue-syndrome-randomized-trial\" target=\"_blank\">Cytokine Inhibition in Patients With Chronic Fatigue Syndrome: A Randomized Trial<\/a> by Megan E. Roerink MD; Sebastian J.H. Bredie, MD, PhD; Michael Heijnen; Charles A. Dinarello, MD; Hans Knoop, PhD; Jos W.M. Van der Meer, MD, PhD <span style=\"text-decoration: underline;\">in<\/span>\u00a0<em>Annals of Internal Medicine<\/em> [Published online: 7 March 2017]<\/p>\n<h3><strong>Comments:<\/strong><\/h3>\n<p><strong>ME association<\/strong> blog post, 8 March 2017, Dr Charles Shepherd: <a href=\"http:\/\/www.meassociation.org.uk\/2017\/03\/why-we-shouldnt-dismiss-the-role-of-pro-inflammatory-cytokines-in-mecfs-comment-on-annals-of-internal-medicine-paper-8-march-2017\/\" target=\"_blank\">Why we shouldn\u2019t dismiss the role of pro-inflammatory cytokines in ME\/CFS: comment on Annals of Internal Medicine paper <\/a><\/p>\n<p><strong>Phoenix rising<\/strong> ME\/CFS Forum posts, 7 March+:\u00a0<a href=\"http:\/\/forums.phoenixrising.me\/index.php?threads\/cytokine-inhibition-in-patients-with-chronic-fatigue-syndrome-a-randomized-trial.49742\/\" target=\"_blank\">Comments by Prof Jonathan Edwards and others<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Research abstract: Background: Interleukin-1 (IL-1), an important proinflammatory cytokine, is suspected to play a role in chronic fatigue syndrome (CFS). Objective: To evaluate the effect of subcutaneous anakinra versus placebo on fatigue severity in female patients with CFS. Design: Randomized, &hellip; <a href=\"https:\/\/wames.org.uk\/cms-english\/cytokine-inhibition-in-cfs\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[3577,3578,1939,3299,318],"class_list":["post-12097","post","type-post","status-publish","format-standard","hentry","category-news","tag-anakinra","tag-interleukin-1-receptor-antagonist","tag-jwm-van-der-meer","tag-megan-e-roerink","tag-proinflammatory-cytokines"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5qkYK-397","_links":{"self":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/12097","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/comments?post=12097"}],"version-history":[{"count":2,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/12097\/revisions"}],"predecessor-version":[{"id":12132,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/12097\/revisions\/12132"}],"wp:attachment":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/media?parent=12097"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/categories?post=12097"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/tags?post=12097"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}