TY - JOUR
T1 - Treatment of myalgic encephalomyelitis/chronic fatigue syndrome
T2 - A systematic review for a National Institutes of health pathways to prevention workshop
AU - Beth Smith, M. E.
AU - Haney, Elizabeth
AU - McDonagh, Marian
AU - Pappas, Miranda
AU - Daeges, Monica
AU - Wasson, Ngoc
AU - Fu, Rongwei
AU - Nelson, Heidi
N1 - Publisher Copyright:
© 2015 American College of Physicians.
PY - 2015/6/16
Y1 - 2015/6/16
N2 - Background: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a debilitating multisystem condition affecting more than 1 million adults in the United States. Purpose: To determine benefits and harms of treatments for adults with ME/CFS and identify future research needs. Data Sources: MEDLINE, PsycINFO, and Cochrane databases (January 1988 to September 2014); clinical trial registries; reference lists; and manufacturer information. Study Selection: English-language randomized trials of the effectiveness and adverse effects of ME/CFS treatments. Data Extraction: Data on participants, study design, analysis, follow-up, and results were extracted and confirmed. Study quality was dual-rated by using prespecified criteria; discrepancies were resolved through consensus. Data Synthesis: Among 35 treatment trials enrolling participants primarily meeting the 1994 Centers for Disease Control and Prevention and Oxford case definitions of CFS, the immune modulator rintatolimod improved some measures of exercise performance compared with placebo in 2 trials (low strength of evidence). Trials of galantamine, hydrocortisone, IgG, valganciclovir, isoprinosine, fluoxetine, and various complementary medicines were inconclusive (insufficient evidence). Counseling therapies and graded exercise therapy compared with no treatment, relaxation, or support improved fatigue, function, global improvement, and work impairment in some trials; counseling therapies also improved quality of life (low to moderate strength of evidence). Harms were rarely reported across studies (insufficient evidence).
AB - Background: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a debilitating multisystem condition affecting more than 1 million adults in the United States. Purpose: To determine benefits and harms of treatments for adults with ME/CFS and identify future research needs. Data Sources: MEDLINE, PsycINFO, and Cochrane databases (January 1988 to September 2014); clinical trial registries; reference lists; and manufacturer information. Study Selection: English-language randomized trials of the effectiveness and adverse effects of ME/CFS treatments. Data Extraction: Data on participants, study design, analysis, follow-up, and results were extracted and confirmed. Study quality was dual-rated by using prespecified criteria; discrepancies were resolved through consensus. Data Synthesis: Among 35 treatment trials enrolling participants primarily meeting the 1994 Centers for Disease Control and Prevention and Oxford case definitions of CFS, the immune modulator rintatolimod improved some measures of exercise performance compared with placebo in 2 trials (low strength of evidence). Trials of galantamine, hydrocortisone, IgG, valganciclovir, isoprinosine, fluoxetine, and various complementary medicines were inconclusive (insufficient evidence). Counseling therapies and graded exercise therapy compared with no treatment, relaxation, or support improved fatigue, function, global improvement, and work impairment in some trials; counseling therapies also improved quality of life (low to moderate strength of evidence). Harms were rarely reported across studies (insufficient evidence).
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U2 - 10.7326/M15-0114
DO - 10.7326/M15-0114
M3 - Review article
C2 - 26075755
AN - SCOPUS:84932135234
SN - 0003-4819
VL - 162
SP - 841
EP - 850
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 12
ER -