longer disease free survival in CFS with antiviral/immunoglobulin treatment than with other treatments

European Review for Medical and Pharmacological Sciences 2013; 17: 2847-2852

Treatment of 741 italian patients with chronic fatigue syndrome

U. TIRELLI, A. LLESHI, M. BERRETTA, M. SPINA, R. TALAMINI1, A. GIACALONE
Department of Medical Oncology, Division of Medical Oncology A, National Cancer Institute of
Aviano, Pordenone, Italy
1Department of Molecular Oncology and Translational Medicine, Unit of Epidemiology and
Biostatistics, National Cancer Institute, Aviano, Pordenone, Italy

Abstract. – 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, CSF still remains
a difficult disease to be effectively treated.

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