Tirelli, U, Lleshi, A, Berretta, M et al. · European review for medical and pharmacological sciences · 2013
This study looked at 741 ME/CFS patients treated at an Italian hospital between 2000 and 2005 to see which treatments helped the most. Antiviral and immunoglobulin drugs (which boost the immune system) showed the best results, with about 15% of patients improving. The study also found that patients who received 4 or more different treatments had better outcomes than those who received fewer treatments.
This is one of the larger treatment studies in ME/CFS, providing real-world evidence about which therapeutic approaches may offer benefit in a substantial patient population. The findings suggest that antiviral/immunoglobulin-based approaches warrant further investigation in controlled trials, and the observation that combination therapy may be more effective than monotherapy has implications for treatment strategy.
This study does not prove antiviral/immunoglobulin drugs are effective, as there were no control groups, placebo comparisons, or randomization. The 15% response rate is modest and could reflect natural disease variation or placebo effect. The study also cannot establish that post-infectious onset is universal in ME/CFS, as it excluded patients not meeting criteria and may reflect selection bias at a specialty institute.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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